Member Service Representative

Remote

• 10am-7pm CST Monday-Friday
• First week of training is onsite in Amarillo, TX

Interested in learning more about this job Scroll down and find out what skills, experience and educational qualifications are needed.

Job Description:

Insight Global's client isseeking 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 xhyhwjd 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