Member Services Specialist

Job Description

Job Description

This is a remote position.

We’re looking to hire a  Healthcare Member Services Specialist who can provide professional support to members and assist with day-to-day healthcare service inquiries. Candidates applying for the role should be highly organized and able to manage multiple questions, requests, and follow-up activities while providing accurate and courteous assistance.

Experience with healthcare administration, member services, insurance, patient support, customer service, or a similar environment is highly valued. Candidates should have strong communication skills, basic knowledge of healthcare services, and an understanding of what excellent member service means.

Ideally, the candidate should be able to resolve routine member inquiries, explain available services and procedures, maintain accurate records, and coordinate with internal teams when additional assistance is required. The candidate should contribute to a positive member experience by providing timely, professional, and solutions-oriented support.

Responsibilities

• Respond to member inquiries by phone, email, and other approved communication channels.
  
• Provide accurate information regarding healthcare services, benefits, procedures, and member resources.
  
• Assist members with routine questions regarding appointments, referrals, coverage, and service requests.
  
• Maintain and update member information in internal databases and systems.
  
• Document member inquiries, requests, concerns, and resolutions accurately.
  
• Coordinate with healthcare providers, internal departments, and other authorized parties when necessary.
  
• Follow up on outstanding member requests to ensure timely resolution.
  
• Assist with scheduling, referrals, authorizations, and other administrative healthcare activities when applicable.
  
• Communicate recurring member concerns and feedback to appropriate internal teams.
  
• Prepare correspondence, reports, forms, and other member-service documentation.
  
• Protect confidential member information and follow applicable privacy and security procedures.
  
• Escalate complex or sensitive issues to the appropriate supervisor or department.
  
• Perform other member-service and healthcare administrative duties as assigned
  

Requirements

• Proven work experience in healthcare member services, patient services, customer service, healthcare administration, or a similar role.
  
• Excellent written and verbal communication skills.
  
• Strong computer skills, including Microsoft Office or comparable productivity software.
  
• Experience with CRM, EHR, insurance, scheduling, or member-management systems is preferred.
  
• Strong organizational and time-management skills.
  
• Ability to manage multiple member inquiries and priorities simultaneously.
  
• Strong attention to detail and accurate recordkeeping skills.
  
• Professional, empathetic, and solutions-oriented communication style.
  
• Strong problem-solving and follow-up skills.
  
• Ability to work independently and collaborate effectively with internal teams.
  
• Ability to maintain confidentiality and appropriately handle sensitive healthcare information.
  
• Knowledge of healthcare terminology, insurance processes, referrals, or member benefits is preferred.
  
• High school diploma or equivalent required; associate’s or bachelor’s degree in Healthcare Administration, Health Services, Business Administration, or a related field is preferred.
  

Benefits

Eligible employees may receive a comprehensive benefits package, including:

• Medical, Dental & Vision Insurance
  
• 401(k) Retirement Plan
  
• Paid Time Off (PTO)
  
• Paid Holidays
  
• Flexible Work Schedule
  
• Remote / Work-from-Home Opportunity
  
• Employee Assistance Program
  
• Professional Development & Training
  

Equal Opportunity

We are committed to providing a professional, respectful, and inclusive workplace. Employment decisions are based on qualifications, experience, skills, organizational needs, and other lawful considerations. Qualified candidates from diverse backgrounds are encouraged to apply.