Member Service Representative

Base pay range

$22.00/hr - $23.00/hr

Member Services Representative

Fountain Valley, CA 92708 (Hybrid)

2-3+ Months

Contract

Top 3 Keywords: 1
- Managed Healthcare/Health Plan Customer Service 2
- Member Grievances & Appeals Processing 3
- Specialty Coding Certification

• Customer Service & Member Support
• Call Center/Transaction Processing
• Communication & Documentation

• Minimum 2 years of experience in a transaction-based or call center environment
• Strong verbal and written communication skills
• Ability to build rapport and demonstrate empathy with members
• Basic computer skills (MS Word, Excel)
• Typing speed of 45 WPM
• Ability to multitask and meet productivity and quality standards
• Attention to detail and strong organizational skills
• Ability to maintain confidentiality (HIPAA compliance)

• Serve as the primary point of contact for members via phone, email, internet, and written correspondence
• Document and track member, provider, and sponsor interactions accurately
• Educate members on benefits, policies, rights, and responsibilities
• Process member grievances, appeals, and service requests
• Review member claims history to ensure accurate benefit tracking

• High School Diploma or GED (required)
• 2+ years of call center or transaction-based experience
• Typing speed of at least 45 words per minute
• Basic proficiency with Microsoft Word and Excel
• Specialty coding certification (required)

• Associate

• Contract

• Health Care Provider

• Hospitals and Health Care