Healthcare Member Services Representative

NOW HIRING: Healthcare Member Services Representative - Onsite Location: Onsite in Ferndale, MI Schedule: Monday, Tuesday & Thursday: 8:00 AM – 5:00 PM Wednesday: 8:00 AM – 3:00 PM Friday: 8:00 AM – 4:30 PM Overview A-Line Staffing is seeking an experienced Customer Service Specialist to join a busy healthcare team in Ferndale, MI. In this role, you will serve as a primary point of contact for health plan members, helping resolve questions, concerns, and service issues while delivering exceptional customer service. The ideal candidate will have strong communication skills, healthcare customer service experience, and the ability to investigate and resolve member concerns in a professional and timely manner. Responsibilities Answer member inquiries by phone, mail, and in person. Research and resolve questions, complaints, appeals, and service issues. Educate members on healthcare plans, benefits, coverage, policies, and procedures. Document all customer interactions accurately and thoroughly. Follow HIPAA guidelines and maintain confidentiality at all times. Coordinate with internal departments to ensure member concerns are resolved. Communicate with healthcare providers and office staff to gather information needed to resolve issues. Monitor outstanding cases and provide timely follow-up with members. Identify service trends and recommend process improvements to enhance the customer experience. Support enrollment activities, outreach efforts, and special departmental projects. Required Minimum of 2 years of recent Customer Service or Call Center experience within the last 3 years Ability to maintain confidentiality and comply with HIPAA regulation Healthcare customer service experience Knowledge of HMO, PPO, POS health plans and medical claims billing Medical Terminology coursework (must be completed within 6 months of employment if not already completed) Why Apply? This is a great opportunity for experienced customer service professionals looking to gain experience within a healthcare environment while helping members navigate their healthcare benefits and services. Alliston Brown | View phone number on click.appcast.io | View email address on click.appcast.io #J-18808-Ljbffr A-Line Staffing Solutions