Member Experience Representative
Milwaukee Succeeds, Goerkes Corner, WI, United States
Now hiring for a remote Member Experience Representative for a healthcare insurance company in Wisconsin. This position is fully remote but requires the candidate to reside in Wisconsin.
Responsibilities
Answer phone or email inquiries from providers, members, customers, or brokers regarding coverage, claim status, benefit interpretation, billing, and authorizations.
Demonstrate proficiency in one line of business (Medicare or Group/Marketplace) and translate healthcare jargon into effective written or verbal communication.
Document interaction details in the database and follow up on any additional action steps.
Demonstrate commitment to the organization’s philosophy, mission, values, and vision.
Appropriately apply all organizational, regulatory, credentialing principles, procedures, requirements, regulations, and policies.
Manage incoming calls efficiently, adhering to metrics and contractual standards.
Probe appropriately to identify caller needs and achieve first call resolution.
Follow up with customers or other departments on outstanding issues, escalating as needed.
Provide proactive support and resolve member questions and concerns.
Use dual monitors and computer‑based resources to find answers and simplify next steps.
Reach out to internal departments or external resources to resolve member concerns.
Protect members' personal health information.
Qualifications
1+ year of healthcare customer service experience.
Proficient in English.
Strong communication skills, both verbal and written.
Ability to handle a high volume of calls while maintaining quality.
Familiarity with healthcare terminology and regulatory requirements is a plus.
Shift
Monday–Friday, 8:00 a.m. – 4:30 p.m.
Job Type & Location
This is a Contract to Hire position based out of Brookfield, WI. Remote—must reside in Wisconsin.
Pay and Benefits
Pay range: $18.25–$18.25 per hour.
Medical, dental & vision
Critical Illness, Accident, and Hospital
401(k) retirement plan – pre‑tax and Roth post‑tax contributions available
Life Insurance (voluntary life & AD&D for employee and dependents)
Short‑term and long‑term disability
Health Spending Account (HSA)
Transportation benefits
Employee Assistance Program
Time Off/Leave (PTO, vacation, or sick leave)
Workplace Type
Fully remote (must reside in Wisconsin).
Application Deadline
This position is anticipated to close on Apr 27, 2026.
Equal Opportunity
The company is an equal‑opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
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Responsibilities
Answer phone or email inquiries from providers, members, customers, or brokers regarding coverage, claim status, benefit interpretation, billing, and authorizations.
Demonstrate proficiency in one line of business (Medicare or Group/Marketplace) and translate healthcare jargon into effective written or verbal communication.
Document interaction details in the database and follow up on any additional action steps.
Demonstrate commitment to the organization’s philosophy, mission, values, and vision.
Appropriately apply all organizational, regulatory, credentialing principles, procedures, requirements, regulations, and policies.
Manage incoming calls efficiently, adhering to metrics and contractual standards.
Probe appropriately to identify caller needs and achieve first call resolution.
Follow up with customers or other departments on outstanding issues, escalating as needed.
Provide proactive support and resolve member questions and concerns.
Use dual monitors and computer‑based resources to find answers and simplify next steps.
Reach out to internal departments or external resources to resolve member concerns.
Protect members' personal health information.
Qualifications
1+ year of healthcare customer service experience.
Proficient in English.
Strong communication skills, both verbal and written.
Ability to handle a high volume of calls while maintaining quality.
Familiarity with healthcare terminology and regulatory requirements is a plus.
Shift
Monday–Friday, 8:00 a.m. – 4:30 p.m.
Job Type & Location
This is a Contract to Hire position based out of Brookfield, WI. Remote—must reside in Wisconsin.
Pay and Benefits
Pay range: $18.25–$18.25 per hour.
Medical, dental & vision
Critical Illness, Accident, and Hospital
401(k) retirement plan – pre‑tax and Roth post‑tax contributions available
Life Insurance (voluntary life & AD&D for employee and dependents)
Short‑term and long‑term disability
Health Spending Account (HSA)
Transportation benefits
Employee Assistance Program
Time Off/Leave (PTO, vacation, or sick leave)
Workplace Type
Fully remote (must reside in Wisconsin).
Application Deadline
This position is anticipated to close on Apr 27, 2026.
Equal Opportunity
The company is an equal‑opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
#J-18808-Ljbffr