Member Service Specialist

Member Service Specialist

Relation Insurance is a leading, innovative company with a strong commitment to excellence and a passion for delivering cutting-edge solutions to our clients. As a key player in the insurance market, we pride ourselves on our dynamic culture, collaborative environment, and continuous drive for success. With a rich history and a bright future ahead, we are looking for exceptional individuals to join our team and contribute to our ongoing growth and success.

The Role

The Member Service Specialist serves as a primary point of contact for members and providers while also providing essential back end and administrative support to ensure timely and accurate resolution of inquiries. The individual in this role is responsible for answering inbound calls, managing shared inboxes, completing follow-up work, conducting research, and performing outbound communications. The Member Service Specialist collaborates closely with internal teams to achieve first call resolution whenever possible and ensures seamless handling of ongoing or complex requests.

A Glimpse Into Your Day

• Answers inbound calls promptly and professionally.
• Strives to achieve first call resolution whenever possible.
• Provides accurate information regarding benefits, services, and requests.
• Accurately documents all calls, actions, and resolutions in call tracking and case management systems.
• Manages and responds to inquiries in shared and assigned inboxes promptly, professionally, and with empathy.
• Completes follow-up work and administrative tasks to support member and provider requests.
• Conducts research and performs outbound communications to resolve inquiries.
• Assigns appropriate call statuses (e.g., First Call Resolution or Open).
• Takes ownership of assigned and claimed tasks to ensure timely completion.
• Communicates follow-up needs clearly and collaborates across teams as required.
• Provides phone coverage during periods of high call volume or operational need.
• Identifies and communicates trends, recurring issues, and process improvement opportunities to leadership.
• Fully adopts innovative technology, including proprietary AI solutions, into the service process to deliver a best-in-class client service experience.
• Performs other projects, duties, and tasks, as assigned.

What Success Looks Like In This Role

• High school diploma or equivalent required.
• Previous customer service experience, preferably in a call center, healthcare, insurance, or administrative support environment.
• Experience in member services, healthcare, or insurance operations preferred.
• Familiarity with shared inboxes, ticketing systems, call tracking, or CRM/case management systems preferred.
• Experience documenting work in CRM or case management platforms preferred.
• Prior experience working in a team-based support environment preferred.
• Strong verbal and written communication skills.
• Ability to multitask, prioritize, and meet response-time expectations in a fast-paced setting.
• High attention to detail and documentation accuracy.
• Professional demeanor with strong interpersonal, collaboration, and time management skills.
• Basic computer proficiency and ability to learn new systems.

Why Choose Relation?

• Competitive pay.
• A safe and healthy work environment provided by our robust benefit program including family health and wellness programs, 401K, employee assistance programs, paid time off, paid holidays and more.
• Career advancement and development opportunities.

Relation Insurance Services