Member service representative

We are a leading healthcare solutions organization dedicated to providing seamless, compassionate care center support and managed care navigation. Operating at the intersection of quality service and patient advocacy, our care team delivers critical non-clinical support across diverse populations-including Commercial, Marketplace, Medicaid, and Medicare programs. We foster a collaborative, high-performance culture focused on continuous learning, operational excellence, and first-call resolution.

salary: $17.99 - $18 per hour
shift: First
work hours: 11:30 AM - 8 PM
education: High School

Responsibilities

What You'll Do

• Serve as the primary front-line contact for healthcare providers and members, actively listening to inquiries and efficiently processing service and authorization requests on the spot.
• Research member eligibility, verify provider network status, and deliver precise authorization updates while strictly maintaining HIPAA and protected health information (PHI) standards.
• De-escalate non-clinical member and provider concerns, guiding callers on required clinical documentation
• Clear-cut messaging regarding appeal decisions, denial updates, request withdrawals, and real-time case status modifications.
• Consistently hit monthly quality targets and identify workflow inefficiencies

What You'll Bring to the Table

• High School Diploma or GED equivalent.
• 1+ years of experience in a high-volume call center setting, with a proven ability to handle 50-100 calls per day seamlessly.
• Familiarity with various health coverage programs, including Commercial, Marketplace, Medicaid, and Medicare lines of business.
• Healthcare Exposure (Preferred): 2+ years of experience within a health plan, Third-Party Administrator (TPA), or related healthcare call center environment.

Why Join Us

• Directly shape the member and provider experience by streamlining access to critical healthcare services.
• Earn $18.00 per hour in a remote environment.
• Monday to Friday, 11:30am-8pm EST (Post-Training).
• Take advantage of dedicated skill development, peer collaboration, and continuous learning opportunities.

Skills

• Call Center Support
• Healthcare System Navigation
• Medicaid
• CRM
• Telephone Etiquette
• Active Listening
• Basic Software Skills

Qualifications

• Years of experience: 1 year
• Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact View email address on click.appcast.io.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.