Member Service Representative

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