Member Services Specialist

Job Description

SNI Companies has partnered with a reputable Healthcare company in the Irving, TX area that is seeking multiple Member Services Specialist to join their team.

The primary focus will be on assisting members with their healthcare-related needs, including but not limited to insurance inquiries, benefit explanations, and general account information. Within the Member Services Specialist team, this entry role provides an opportunity for growth and development within the organization.

Responsibilities :

• Respond to inbound calls, emails, and member chat messages regarding healthcare-related questions and concerns.
• Assist members in navigating the healthcare system and understanding their rights and responsibilities.
• Investigate and resolve member complaints, issues, and escalations promptly and satisfactorily.
• Document all customer interactions and issue resolutions accurately and comprehensively in the CRM system.
• Collaborate with internal departments to facilitate issue resolution and ensure a seamless customer experience.
• Explain insurance plans, policies, and procedures to members, ensuring they understand their benefits and coverage clearly.
• Provide guidance on accessing healthcare services, locating in-network providers, and understanding pre-authorization requirements.

Requirements :