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Member Services Representative
Member Services RepresentativeSelect Source International • Akron, OH, United States
Member Services Representative

Member Services Representative

Select Source International • Akron, OH, United States
5 hours ago
Job type
  • Full-time
  • Quick Apply
Job description

Summary of Position -

  • The Member Services Representative provides personalized, high-quality service to health plan members by promptly addressing inquiries and resolving concerns.
  • This role involves coordinating with management and other departments to ensure member satisfaction, maintaining accurate documentation, and demonstrating a thorough understanding of health insurance operations, including Medicare-related services.

Essential Functions -

  • Provide personalized service to members via phone, email, or in-person regarding Enrollment, benefits, eligibility, billing, claims, and authorizations.
  • Record all member inquiries and complaints accurately in the tracking system, ensuring timely follow-up and resolution.
  • Meet or exceed departmental production and quality standards for all communications.
  • Treat all customers with respect, empathy, and professionalism while maintaining a service-oriented attitude.
  • Demonstrate working knowledge of health insurance practices, including regulatory rules, benefit structures, and internal systems such as Amisys and Macess .
  • Exercise independent judgment and problem-solving skills to address member concerns effectively.
  • Communicate clearly and confidently both verbally and in writing.
  • Manage time efficiently in a fast-paced call center environment.
  • Maintain strict confidentiality of member health and business information.
  • Adhere to all company, departmental, and regulatory policies and procedures.

    • Minimum Qualifications -

    Education -

  • High School Diploma or GED required.
  • College coursework or degree preferred.

    • Experience & Training -

  • Minimum 1+ year of relevant experience in a customer service , call center , or administrative support role.
  • Prior experience in Medicare and / or health insurance strongly preferred.

    • Experience Required : Minimum 1 year relevant experience

    Skills & Competencies -

  • Strong understanding of customer service practices, including phone etiquette and documentation workflows.
  • Excellent written and verbal communication skills.
  • Proficient in Windows and computer-based information management.
  • Professional demeanor with a compassionate, customer-first approach.
  • Adept at operating standard office equipment (computer, headset, etc.) with strong keyboarding and system navigation skills.
  • Knowledge or ability to learn health insurance terminology, governing rules, and compliance regulations.
  • Effective organizational, time management, and multitasking abilities.
  • Ability to maintain confidentiality and comply with HIPAA standards.
  • Flexibility to adjust work hours as needed and comfort working remotely if required.
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    Member Service Representative • Akron, OH, United States