Member Service Representative
Insight Global
Remote
- 10am-7pm CST Monday-Friday
- First week of training is onsite in Amarillo, TX
Job Description:
Insight Global's client is seeking a compassionate, detail-oriented Member Services Representative to join a rapidly growing healthcare organization focused on delivering an exceptional member experience while reducing healthcare costs. In this role, you'll serve as a trusted resource for health plan members and healthcare providers, helping them understand coverage, benefits, claims, billing issues, and eligibility information.
Preferred Experience:
- 2+ years of customer service experience in healthcare background
- Call center and customer service experience required
- Strong communication and problem-solving skills
- Ability to navigate sensitive situations with empathy and professionalism
- High attention to detail and strong follow-through
Responsibilities:
- Support members through inbound calls, email, and chat interactions
- Explain healthcare benefits, eligibility, claim status, and EOBs
- Assist members with billing questions and provider access issues
- Work directly with healthcare providers regarding benefits, eligibility, payments, and claims inquiries
- Investigate and resolve member and provider concerns from start to finish
- Collaborate with internal teams to improve member outcomes and experiences
- Maintain HIPAA compliance and accurate documentation
Pluses:
- Bilingual English/Spanish
- Experience supporting self-funded health plans, TPAs, or healthcare payers
- Knowledge of medical billing or balance billing situations
- Experience assisting both members and providers
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