Member Services Representative

Apex Systems, LLC

Akron, OH

Member Services RepresentativeApply**Job#: 3053178****Job Description:**We are seeking a customer-focused and empathetic Member Services Representative II to serve as a trusted resource for members seeking assistance with their healthcare benefits and insurance-related inquiries. This individual will play a critical role in delivering a high-quality member experience by providing accurate information, resolving issues efficiently, and ensuring compliance with healthcare regulations and company standards.The ideal candidate will have previous experience in a customer service or call center environment, possess strong communication skills, and demonstrate the ability to navigate complex healthcare and insurance-related questions. This role requires a balance of professionalism, problem-solving abilities, empathy, and attention to detail while supporting members through a variety of benefit and coverage inquiries.**Key Responsibilities****Member Support & Customer Service*** Serve as the primary point of contact for members via phone, email, and other communication channels.* Assist members with questions related to health insurance benefits, eligibility, enrollment, claims processing, billing inquiries, authorizations, and coverage concerns.* Provide personalized support while educating members on available benefits, programs, and resources.* Resolve member issues efficiently while ensuring a positive customer experience during each interaction.* Escalate complex issues to appropriate internal departments and coordinate resolution efforts on behalf of members.**Case Management & Documentation*** Accurately document all member interactions, concerns, complaints, and resolutions within internal tracking systems.* Maintain detailed records that comply with organizational standards, regulatory requirements, and quality assurance guidelines.* Track open issues and monitor follow-up activities to ensure timely resolution.**Quality & Performance*** Consistently meet or exceed established service-level goals, productivity metrics, quality standards, and member satisfaction expectations.* Demonstrate professionalism, empathy, and active listening during all member interactions.* Utilize proper call-handling techniques while effectively managing multiple priorities in a fast-paced environment.**Compliance & Industry Knowledge*** Maintain a strong understanding of health insurance products, Medicare guidelines, eligibility rules, claims processes, and industry regulations.* Stay current on changes in healthcare regulations, organizational policies, and operational procedures.* Handle protected health information (PHI) and confidential business information in accordance with HIPAA and company privacy standards.* Ensure compliance with all departmental, regulatory, and organizational requirements.**Collaboration & Problem Resolution*** Partner with internal departments including Enrollment, Claims, Billing, Care Management, and Provider Relations to resolve member concerns.* Use analytical thinking and independent judgment to determine appropriate solutions based on policy and procedure.* Identify trends in member concerns and provide feedback that may improve processes or member satisfaction.**Required Qualifications****Education*** High School Diploma or GED required.* Associate's degree or some college coursework preferred.**Experience*** Minimum of 2 years of customer service, member services, call center, healthcare administration, insurance operations, or related experience.* Prior experience supporting Medicare members, health insurance plans, or healthcare-related services is strongly preferred.* Experience working in a metrics-driven or performance-focused environment preferred.**Desired Skills & Competencies****Customer Service Excellence*** Exceptional communication and interpersonal skills.* Demonstrated ability to build rapport and establish trust with members.* Strong conflict resolution and de-escalation skills.* Ability to display empathy while maintaining professionalism and efficiency.**Technical Skills*** Proficiency with Microsoft Windows applications and computer-based systems.* Ability to navigate multiple software applications simultaneously while engaging with members.* Experience with customer relationship management (CRM) platforms, case management systems, or healthcare administration software is preferred.* Comfortable using VPN access, remote work technologies, headsets, and virtual communication tools.**Organizational Skills*** Strong attention to detail and accuracy in documentation.* Excellent time management and prioritization abilities.* Ability to manage a high volume of requests while maintaining service quality.**Critical Thinking*** Demonstrates sound judgment and decision-making capabilities.* Ability to interpret policies, procedures, and benefit guidelines to resolve member concerns.* Strong analytical and problem-solving skills.**Work Environment*** Primarily remote and telephone-based customer service environment.* Extensive interaction with members throughout the workday.* Fast-paced setting with performance expectations related to quality, productivity, and member satisfaction.* Flexible schedule may be required to support business needs.**Physical Requirements*** Ability to sit for extended periods while working on a computer and handling member calls.* Manual dexterity required for keyboarding and system navigation.* Ability to occasionally bend, stoop, stretch, and lift up to 20 pounds.* Must be able to effectively use a computer, headset, telephone, and standard office equipment.**Ideal Candidate Profile**The successful candidate will be a compassionate and detail-oriented customer service professional who enjoys helping others navigate healthcare-related questions and challenges. They will possess strong communication skills, thrive in a fast-paced environment, demonstrate accountability for results, and consistently deliver an exceptional member experience while maintaining compliance and confidentiality standards.EEO EmployerApex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Employee Services Department at View email address on click.appcast.io or View phone number on click.appcast.io. *Everforth Apex is a world-class IT services company that serves thousands of clients across the globe. When you join Everforth Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRateds Best of Staffing in Talent Satisfaction in the United States and Great Place to Work in the United Kingdom and Mexico.**Everforth Apex uses a virtual recruiter as part of the application process. Click here for more details. By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from Everforth Apex and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy at Apex Benefits Overview: Everforth Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection. We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure. Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts. In terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Everforth Apex has a dedicated customer service team for our Consultants that can address questions around benefits and other resources, as well as a certified Career Coach. You can access a full list of our benefits, programs, support teams and resources within our ‘Welcome Packet’ as well, which an Everforth Apex team member can provide.**Everforth Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Everforth Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law.**If you require an accommodation under the Americans with Disabilities Act to participate in an interview with a virtual recruiter or to use our website for a search or application, please contact our Benefits Department at View email address on click.appcast.io or View phone number on click.appcast.io. Please note that this contact information is strictly to be used for medical ADA accommodations and that no other inquiries will be answered.**UnitedHealthcare creates and publishes the Transparency in Coverage Machine-Readable Files on behalf of Everforth Apex Systems.***Employee Type:** Contract**Location:** Akron, OH, US**Job Type:****Date Posted:** September 23, 2026**Pay Range:** $16 - $17 per hour
J-18808-Ljbffr Apex Systems, LLC

Apply

Vacancy posted 19 hours ago

Similar jobs that could be interesting for youBased on the Member Services Representative in Akron, OH vacancy

Customer Service Representative - State Farm Agent Team Member
$45k - $65k
...Customer Service Representative – Service-Focused with In-Book Sales Goals Meghan MacDonald State Farm Agency Location 756 Graham Road, Cuyahoga... ...all customer interactions Collaborate with agency team members to deliver a seamless customer experience What We're...
Suggested
Base plus commission
Full time
For contractors
Work at office
Meghan MacDonald - State Farm Insurance Agent
Cuyahoga Falls, OH
4 days ago
Client Service Rep, Call Center - Remote
...Member Services Representative II We are seeking a customer-focused and empathetic Member Services Representative II to serve as a trusted resource for members seeking assistance with their healthcare benefits and insurance-related inquiries. This individual will play...
Suggested
Work at office
Remote work
Flexible hours
Apex Systems
Akron, OH
2 days ago
Customer Service Representative - State Farm Agent Team Member
$45k - $65k
...Customer Service Representative Service-Focused with In-Book Sales Goals Meghan MacDonald State Farm Agency Location 756 Graham Road, Cuyahoga... ...all customer interactions Collaborate with agency team members to deliver a seamless customer experience What We're...
Suggested
Base plus commission
Full time
For contractors
Work at office
Meghan MacDonald - State Farm Insurance Agent
Cuyahoga Falls, OH
2 days ago
Crew Member: Customer Service / Cashier
...The Crew Member: Customer Service / Cashier is the key to ensuring guest satisfaction. This is a very important position for a friendly, helpful individual who enjoys working in a fast-paced environment. Why should you apply? Free Meals during your shift...
Suggested
Flexible hours
Shift work
Taco Bell
Akron, OH
2 days ago
Crew Member: Customer Service / Cashier
...Crew Member: Customer Service / CashierThe Crew Member: Customer Service / Cashier is the key to ensuring guest satisfaction. This is a very important position for a friendly, helpful individual who enjoys working in a fast-paced environment.Why should you apply?Free...
Suggested
Flexible hours
Long John Silver's
Akron, OH
2 days ago
WFH Customer Service Team Member
...assisting both existing and potential clients within our organization. As a valued team member, you will engage with multiple clients throughout the day, delivering exceptional service and demonstrating in-depth product knowledge. Preferred Skills Excellent communication...
Weekly pay
Remote work
Work from home
Flexible hours
AO Globe Life
Akron, OH
2 days ago
Store Team Member
...Sheetz Store Team Member Additional $1.50/hr. for working 10pm-6am Got high-energy and love to hustle? Come join the fast-paced... ...facets of the store through sales, food preparation & customer service. The sky is the limit for your potential to grow within Sheetz....
Sheetz
Tallmadge, OH
2 days ago
Store Team Member
...Come join the fast-paced, FUN work atmosphere as a Store Team Member and MAKE SHEETZ HAPPEN!We call this role a 'team member' because... ...facets of the store through sales, food preparation & customer service. The sky is the limit for your potential to grow within Sheetz....
Sheetz
Akron, OH
2 days ago
Store Team Member
...Come join the fast-paced, fun work atmosphere as a Store Team Member and make Sheetz happen!We call this role a 'team member' because... ...facets of the store through sales, food preparation & customer service. The sky is the limit for your potential to grow within Sheetz....
Sheetz
Cuyahoga Falls, OH
2 days ago
Customer Service Representative - State Farm Agent Team Member
$33k - $45k
...great place to build a career because we focus on helping team members grow their skillsets, offering internal promotions, and... ...feel right at home here. Job Description: As a Customer Service Representative - State Farm Agent Team Member, you'll be at the forefront...
For contractors
Work at office
Local area
Flexible hours
State Farm
Mogadore, OH
1 day ago
Customer Service Representative - State Farm Agent Team Member
$33k - $45k
...Customer Service Representative - State Farm Agent Team Member As a Customer Service Representative - State Farm Agent Team Member, you'll be at the forefront of delivering an exceptional customer experience. Your responsibilities will include: Engaging with customers...
Brian Hoy - State Farm Agent
Mogadore, OH
5 days ago
Customer Service Representative - State Farm Agent Team Member
$40k - $46k
...market State Farm Insurance and financial services products. ROLE DESCRIPTION: As a Customer Service Representative with KARLIE NEWTON II - State Farm Agent,... ...inquiries, coordinating with other agent team members, and anticipating the needs of the...
For contractors
Work at office
Immediate start
Flexible hours
State Farm
Stow, OH
1 day ago
Customer Service Representative - State Farm Agent Team Member
$17 - $19 per hour
...relationships, and thrive in a team-oriented environment? As a Customer Service Representative with our agency, you will play a key role in providing... ...a very busy office and are looking for our next great team member. This busy insurance and financial services office has a...
Hourly pay
For contractors
Work at office
State Farm
Barberton, OH
1 day ago
1st Shift Member Services Representative
$13 per hour
...Member Services Representative The Member Services Representative will be responsible for creating a positive member experience by providing a superior level of customer service to Planet Fitness members, prospective members and guests. We are presently hiring for...
Hourly pay
Shift work
Day shift
Planet Fitness
Wadsworth, OH
4 days ago
Store Team Member (Cashier, Stocker, Animal Care)
...Store Team Member Did you know bearded dragons grow up to 2 feet long? Or that the average life span for an umbrella cockatoo is... ...about people and their pets. Providing exceptional, neighborly service at every opportunity during your workday, you will: stop to...
Full time
Local area
Flexible hours
Weekend work
Afternoon shift
Pet Supplies Plus
Akron, OH
4 days ago
Crew Member: Customer Service / Cashier
The Crew Member: Customer Service / Cashier is the key to ensuring guest satisfaction. This is a very important position for a friendly, helpful individual who enjoys working in a fast-paced environment. Why should you apply? Free Meals during your shift Flexible Scheduling...
Flexible hours
Shift work
Long John Silver's
Akron, OH
4 days ago
Account Representative - State Farm Agent Team Member
$40k - $60k
...Account Representative - State Farm Agent Team MemberAs Account Representative - State Farm Agent Team Member for KARLIE NEWTON II - State Farm Agent, you are vital to our daily business... ...marketing relevant products and services. Grow your career as you better your community...
For contractors
Work at office
Immediate start
Karlie Newton Ii - State Farm Agent
Fairlawn, OH
3 days ago
Member Service Representative
$11 - $11.5 per hour
Job Title Location 623 School Dr, Wadsworth, OH, 44281, United States Base Pay $11.00 - $11.50 / Hour Job Category Member Experience Employee Type PT Non-Exempt Required Degree NONE Manage Others No Job Description Description Akron Area YMCA
Akron Area YMCA
Wadsworth, OH
5 days ago
Account Manager - State Farm Agent Team Member
$50k - $70k
...performance metrics to meet and exceed goals Collaborate with team members to support overall agency production targets What We're... ..., OH and help customers with their insurance and financial services needs, including: Auto insurance Home insurance Life insurance...
Base plus commission
Full time
For contractors
Work at office
State Farm
Cuyahoga Falls, OH
1 day ago
Janitorial Crew Member (2nd and 3rd shift)
...known for dependable staff, high professional standards, and consistent service across the region. We take pride in creating clean and healthy environments for our clients while supporting our team members with the tools and training they need to succeed. Clean Team Inc is...
Full time
Monday to Friday
Flexible hours
Shift work
Night shift
Weekend work
Afternoon shift
Clean Team, Inc.
Akron, OH
19 hours ago
Customer Service Representative
...facilities. Come Join Our Team! Description Customer Service Representative will be involved with and responsible for providing a high... ...Ability to work independently and take initiative to help team members during downtime Contribute ideas on ways to resolve...
Full time
Temporary work
Work at office
Local area
Remote work
Shift work
Weekend work
Coltene
Cuyahoga Falls, OH
2 days ago
Alterations Customer Service Representative
...for weekends only!) ~ Generous Team Member discount ~$400 bonus for every referral... ...them with one of the highest customer service scores in retail! We make... ...The Alterations Customer Service Representative (CSR) is a critical role for the successful...
Hourly pay
Part time
Weekend work
Weekday work
David's Bridal
Akron, OH
2 days ago
Insurance Account Representative - State Farm Agent Team Member
$35k - $60k
...Insurance Account Representative - State Farm Agent Team MemberSuccessful State Farm Agent is... ...needs, and market appropriate products and services.Maintain a strong work ethic with a... ...success each and every day.As an Agent Team Member, you will receive...Salary plus...
For contractors
Work at office
Immediate start
Karlie Newton Ii - State Farm Agent
Fairlawn, OH
3 days ago
Banking Teller, Member Service Representative
...financially and support the communities we serve. We’re looking for team members who share our commitment to service, integrity, and community impact. Position Overview As a Member Service Representative , you’ll be the first point of contact for our members—providing...
Immediate start
7 17 Credit Union
Kent, OH
more than 2 months ago
Retail In-store Crew Member
...Brand Ambassador As a brand ambassador, team members will help our guests meet their fitness and nutrition goals by assisting them... ...about health and fitness Strong interpersonal and customer service skills Food service experience preferred, but not required...
Flexible hours
Smoothie King
Akron, OH
2 days ago
Crew Member - Flexible Shifts
...Crew Member Business is gang busters! Starting pay based on skill level! We train. Become part of a quality company helping to ensure quality products are served and quality service is provided! Better ingredients, better people, Papa Johns. Great for first time...
Hourly pay
Flexible hours
Shift work
Papa John's Pizza
Cuyahoga Falls, OH
5 days ago
Crew Member
$12 - $14 per hour
...Five Guys Burgers and Fries Crew Member Starting Pay is $12-$14/hour + Tips & Bonus ($2/hour avg) Five Guys Burgers and Fries... ...about fresh ingredients, food safety, cleanliness, and customer service. No freezers in our restaurants. Earn, learn and grow your career...
Flexible hours
Shift work
Day shift
Afternoon shift
Five Guys
Fairlawn, OH
4 days ago
Crew Member
...confident working at any station – grill, cashier, prep, salsa and expo. We take pride in our exceptional customer service and it’s up to each of our team members to create the friendly atmosphere that our customers expect and enjoy. So, whether you have experience as a...
Full time
Part time
Local area
Shift work
Chipotle Mexican Grill
Cuyahoga Falls, OH
1 day ago
Insurance Account Representative - State Farm Agent Team Member
$35k - $60k
...Insurance Account Representative - State Farm Agent Team Member Successful State Farm Agent is seeking a qualified professional to join their winning... ...customer needs, and market appropriate products and services. Maintain a strong work ethic with a total commitment...
For contractors
Work at office
Immediate start
Karlie Newton Ii - State Farm Agent
Fairlawn, OH
3 days ago
Customer Retention Specialist - State Farm Agent Team Member
$45k - $65k
...Customer Retention Specialist Service-Focused with In-Book Sales Goals The Meghan MacDonald State Farm Agency is seeking a Customer... ...customer interactions and follow-up activity Collaborate with team members to support retention, service standards, and growth objectives...
Base plus commission
For contractors
Meghan Macdonald - State Farm Agent
Cuyahoga Falls, OH
2 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Member Services Representative. Be the first to apply!