Member Benefits Specialist - Member Services Professional
$41,600,000–$47,840,000 year
RemoteUnited States
United StatesRemoteFull Time$41,600,000–$47,840,000 yearHigh School Or EquivalentMedium
Full TimeHigh School Or EquivalentMedium
Job Summary
Conduct inbound calls, email, and portal inquiries to serve as a single point of contact for member benefit plan questions. Act as an advocate by educating members on resources, Flexible Spending Accounts, and health coverage details while resolving complaints and reducing handoffs. Anticipate member needs, conduct research on their behalf, and manage appointment scheduling and medical record retrieval in compliance with HIPAA guidelines and federal regulations. Maintain accurate documentation across all channels and collaborate with internal and external partners to ensure consistent service delivery.
Required Qualifications
- High school diploma or GED
- 1+ year healthcare industry work experience
- Experience in delivering client-focused solutions based on customer needs within direct member contact and education
- Ideally virtual/telephonic, in-person experience with the public
- 1+ year with telephonic verification of medical benefits
- 2+ years healthcare experience i.e. carrier, TPA, patient advocate, or other benefits focused role
- Medical claims exposure (ICD-9/10 coding, CPT coding, and medical claim forms)
- Proficient in Microsoft Outlook, Word and Excel
- Service-driven mindset
- Aptitude for learning and retention
- Advanced soft skills with a high level of emotional intelligence
- Strong written communication skills
Desired Qualifications
- Ideally virtual/telephonic, in-person experience with the public
- 1+ year with telephonic verification of medical benefits preferred
- 2+ years healthcare experience i.e. carrier, TPA, patient advocate, or other benefits focused role preferred
- Medical claims exposure (ICD-9/10 coding, CPT coding, and medical claim forms) preferred
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