This is a remote position after training on site. We are seeking a customer-focused Member Services Representative who is passionate about helping others. This is an inbound call center supporting members and promptly works to answer questions and resolve concerns. Coordinates with management and other departments to effectively address member needs.
The ideal candidate: Call center + healthcare /insurance billing/claims experience. Also, we strongly preferred good typing skills, comfortable with on the job medical terminology along with a background in Medicare and/or health insurance.
Key Responsibilities:
- Provide personalized assistance to members via phone and electronic communication regarding enrollment, benefits, eligibility, billing, claims, and authorizations
- Accurately document all member inquiries and complaints in the tracking system and route issues for timely resolution
- Meet or exceed departmental quality and productivity standards for both written and telephonic communications
- Consistently apply the Three Es—Empathy, Education, and Empowerment—in all member interactions
- Utilize Plan Central, Amisys and Macess systems to research and resolve customer inquiries
- Deliver timely, professional internal and external customer service with integrity and respect
- Exercise independent judgment and problem-solving skills within established policies and procedures
- Maintain focus and attention to detail while managing multiple tasks and performance expectations
Minimum QualificationsEducation
- High School Diploma or GED required
Experience
- Minimum of one year of experience in a similar role
- Relevant experience includes customer service in information management, call centers, receptionist roles, or administrative support
- Skills & Competencies
- Knowledge of Member Services best practices
- Strong verbal and written communication skills
- Proficiency in Windows-based systems and organizing computer-based information
- Ability to balance professionalism with a warm, customer-first approach
- Demonstrated empathy, confidence, and service-oriented tone over the phone
- Ability to learn and apply health insurance regulations, policies, and procedures
- Strong time-management and organizational skills in a fast-paced environment
- Commitment to confidentiality of member health and business information
- Flexibility to adjust work hours based on business needs
- Ability to operate standard office equipment
- Typing (25-30 WPM and 80 to 85% accuracy ) and Medical terminology testing is requiredPhysical Requirements
- Ability to sit for extended periods
- Ability to bend, stoop, and stretch as needed
- Manual dexterity to operate computers, phones, and standard office equipment
- Ability to work independently
Work Environment
- Moderate complexity role requiring independent decision-making and problem solving
- Moderate stress level with frequent multitasking, close attention to detail, and performance accountability
- This is a train on-site (roughly for a month) and then transition to remote role.
#AKR123
Pay: From $21.50 per hour
Work Location: Hybrid remote in Akron, OH 44312
