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Member Service Representative

Full-time

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
Vacancy posted 3 hours ago
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