Job Title:
Member Services Representative
Overview We are seeking a professional and detail-oriented Member Services Representative to support members by handling a high volume of inbound calls and providing accurate, timely assistance related to health plan benefits and services. This role requires strong communication skills, attention to detail, and the ability to work efficiently in a fast-paced environment.
Key Responsibilities
Answer a high volume of inbound member calls (approximately 50–60 per day) in a professional, courteous, and timely manner
Provide accurate information regarding benefits, coverage, claims status, and eligibility
Clearly and accurately document all member interactions in the system
Resolve member issues efficiently and elevate complex concerns to appropriate internal teams as needed
Assist members in navigating health plan resources, tools, and available services
Adhere to all compliance requirements, including HIPAA and internal company policies
Meet or exceed established performance metrics related to call quality, response time, and member satisfaction
Required Qualifications
Official diploma (no transcripts or copies accepted)
Experience working in a high-volume inbound call environment
Professional demeanor with strong attention to detail and customer service skills
Preferred Qualifications
Experience or knowledge of TRICARE programs
Schedule & Work Arrangement
Hybrid Schedule (Mandatory In-Office Days)
Monday - Friday 9am - 5pm
Why Join Us
Stable weekday schedule with hybrid work structure
Opportunity to support members in a meaningful, service-driven role
Collaborative team environment with clear performance expectations
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Member Services Representative
Overview We are seeking a professional and detail-oriented Member Services Representative to support members by handling a high volume of inbound calls and providing accurate, timely assistance related to health plan benefits and services. This role requires strong communication skills, attention to detail, and the ability to work efficiently in a fast-paced environment.
Key Responsibilities
Answer a high volume of inbound member calls (approximately 50–60 per day) in a professional, courteous, and timely manner
Provide accurate information regarding benefits, coverage, claims status, and eligibility
Clearly and accurately document all member interactions in the system
Resolve member issues efficiently and elevate complex concerns to appropriate internal teams as needed
Assist members in navigating health plan resources, tools, and available services
Adhere to all compliance requirements, including HIPAA and internal company policies
Meet or exceed established performance metrics related to call quality, response time, and member satisfaction
Required Qualifications
Official diploma (no transcripts or copies accepted)
Experience working in a high-volume inbound call environment
Professional demeanor with strong attention to detail and customer service skills
Preferred Qualifications
Experience or knowledge of TRICARE programs
Schedule & Work Arrangement
Hybrid Schedule (Mandatory In-Office Days)
Monday - Friday 9am - 5pm
Why Join Us
Stable weekday schedule with hybrid work structure
Opportunity to support members in a meaningful, service-driven role
Collaborative team environment with clear performance expectations
#J-18808-Ljbffr