Member Service Representative Level 1
for section headings like About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We need to include sections only when posting has real specific content. We have description about organization, position summary, duties, privacy and security responsibilities, requirements, preferred skills, career development, benefits. No explicit Pay or Schedule details (though schedule mentioned: hybrid schedule, averaging 2 scheduled days in-office per week). That is schedule info. So we can include Schedule section. Pay not mentioned, so omit. Benefits section present. Qualifications? Could combine Requirements and Qualifications? We have Requirements (education, job requirements). Could treat as Requirements section. Qualifications maybe same; but we can include Requirements and maybe Qualifications if distinct. The posting has "Education Requirements:" and "Job Requirements". Also "Preferred Skills". So we can have sections: About the role (maybe from description and position summary), Responsibilities (Key Duties And Responsibilities plus Privacy And Security Responsibilities), Requirements (Education Requirements, Job Requirements), Skills (Preferred Skills), Benefits, Schedule.
We must not repeat job title as heading. Use for each section heading. Use - for any list of duties/requirements/benefits. Use
for prose.
We need to preserve all substantive information, not invent or summarize away detail. Remove boilerplate: EEO etc. Remove cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, and application instructions. The posting includes EEO statement at end; we should remove that. Also remove "Career Development & Continuing Education Opportunities: Yes" maybe keep? It's substantive? It's a benefit? Could be part of Benefits? It's not a benefit per se but could be included in Benefits? Might be considered a benefit. But we have Benefits section already; we could include that line there. However instruction: include a section ONLY when posting has real, specific content for it — never emit a heading followed by filler/placeholder text. "Career Development & Continuing Education Opportunities: Yes" is specific; we could put under Benefits or maybe a separate section? Not among allowed headings; we could incorporate into Benefits as a bullet.
We must not include duplicated lines. Need to extract duties list.
Let's parse content:
Description paragraph about organization.
Position Summary paragraph.
Key Duties And Responsibilities: many bullet-like sentences separated by periods. We need to turn into list items.
Privacy And Security Responsibilities: paragraph.
Requirements: Education Requirements: High school diploma or GED; Customer service certification preferred.
Job Requirements: 1–2 years of customer service experience in healthcare (benefits administration preferred); Ability to understand and explain basic enrollment, eligibility, and benefit information; Call center training or experience; Typing speed of 35 wpm or higher, with accuracy; Work a hybrid schedule, averaging 2 scheduled days in-office per week, dependent on department operations and performance; Strong written and verbal communication skills; Strong listening, interpersonal, and problem-solving skills; Proficiency with Microsoft Office (Word, Excel, Outlook) and office equipment (printers, scanners, fax, etc.); Excellent organization, time management, and attention to detail; Ability to meet deadlines and work independently or within a team; Accountability and ability to work cooperatively across departments; Flexibility to assist with special projects and handle multiple tasks.
Preferred Skills: Basic skills in Microsoft PowerPoint; Bilingual (Ukrainian, Spanish preferred); Understanding of health insurance claims, as well as an ability to analyze data to resolve provider service issues; Experience with benefit administration systems (Bridgeway); Experience with Smartsheet or other project management tools; Remote work experience (laptop provided); Experience with virtual conference software (Teams, Zoom); Awareness of labor movements, social issues, and political factors impacting the organization.
Benefits: SEIU Healthcare IL Benefit Funds offers a comprehensive health benefits (medical, dental and vision coverage) for employees and eligible dependents, including no employee premium option for employee only; competitive compensation; generous holidays and PTO policies; and a pension retirement plan.
Schedule: hybrid schedule, averaging 2 scheduled days in-office per week.
We need to avoid repeating schedule info in Requirements and also have Schedule section. The schedule is mentioned in Job Requirements; we could keep it there but also have Schedule section. Might be duplicate. Better to move schedule info to Schedule section and remove from Requirements to avoid duplication. However instruction: Preserve ALL substantive information; do NOT invent or summarize away detail. If we remove it from Requirements, we lose that detail unless we keep it elsewhere. We can keep it in both places? That would be duplication. Better to keep it in Schedule section and note that it's also a requirement? But we must preserve all info; we can keep it in Schedule section and also mention in Requirements as part of job requirements? That would be duplicate. The instruction says remove duplicated lines. So we should avoid duplication. So we need to decide where to place schedule info. Since there is a dedicated Schedule section, we can put schedule info there and not duplicate in Requirements. However the Requirements section originally includes schedule as a job requirement; moving it may be considered omitting that detail from Requirements but we still preserve it overall. That's acceptable as we are not losing info, just relocating. The instruction: "Preserve ALL substantive information; do NOT invent or summarize away detail." So as long as we keep the info somewhere, it's fine.
Thus we will have Schedule section with that detail.
Now we need to format.
Sections:
About the role
-> combine description and position summary paragraphs into prose ().
Responsibilities
-> list items from Key Duties And Responsibilities and Privacy And Security Responsibilities.
We need to split into list items. Each sentence could be an item. Let's extract sentences:
Key Duties And Responsibilities sentences (separated by periods):
1. Professionally handle incoming calls and inquiries from plan participants, medical providers, vendors, and medical partners for all health plans with excellent quality service.
2. Follow scripts, policies, procedures, and plan documents to ensure first -call resolution.
3. Able to perform in a high call volume environment with the ability to provide quality service effectively by phone, in-person, and virtually
4. Resolve any open issues requested from calls, voicemail, and walk-ins while documenting all interactions accurately
5. Provide translation support across departments when needed
6. Meet established call center performance metrics and contribute to improvement initiatives
7. Process enrollments with accurate data entry into the benefits administration system
8. Use project management software (Smartsheet) to track daily requests
9. Have working knowledge on the guidelines of the Fund’s nine (9) health plans while referencing appropriate summary plan descriptions
10. Educate members on eligibility, covered and non-covered services, benefit options, and best practices for healthcare use
11. Provide members and providers with status on claims submission process, medical claim status, benefits, eligibility, member appeal rights, referral requirements and provider reconsiderations
12. Conduct proactive outreach to plan participants to provide education regarding benefits, eligibility requirements, and referral requirements
13. Collaborate with internal departments and healthcare partners to identify members who may benefit from outreach or additional assistance
14. Handle eligibility-related inquiries and disputes by reviewing member records, contributions, and supporting documentation to determine next steps
15. Perform follow-up calls or communications with members to ensure issues have been resolved
16. Track and manage member and provider requests and inquiries
17. Handle network escalations within a 48-hour turnaround time
18. Attend and participate in various meetings, including All Staff meetings, department meetings, training sessions, task force or committee meetings, and other meetings deemed appropriate to share, discuss, and solution for question or error trends, as well as identify potential process improvements
19. Create one-on-one (1:1) agendas with the Member Service Supervisor using the Purpose,Outcome and Process (POP) Model and keeping thorough notes for each meeting
Privacy And Security Responsibilities paragraph: "This position requires handling Personally Identifiable Information (PII) and Protected Health Information (PHI). The MSR is responsible for maintaining the confidentiality, integrity, and security of all PII and PHI and must report any suspected identity or HIPAA violations to the HIPAA Privacy and Security Officers."
We can split into two items or keep as one paragraph? Since it's prose, we could keep as under Responsibilities? But instruction: Use
- for any list of duties/requirements/benefits. This is a duty/responsibility, so list item. Could be two items.
We'll make two items:
- This position requires handling Personally Identifiable Information (PII) and Protected Health Information (PHI).
- The MSR is responsible for maintaining the confidentiality, integrity, and security of all PII and PHI and must report any suspected identity or HIPAA violations to the HIPAA Privacy and Security Officers.
Now Requirements section: Education Requirements and Job Requirements (excluding schedule). We'll list items.
Education Requirements:
- High school diploma or GED
- Customer service certification preferred
Job Requirements (excluding schedule):
- 1–2 years of customer service experience in healthcare (benefits administration preferred)
- Ability to understand and explain basic enrollment, eligibility, and benefit information
- Call center training or experience
- Typing speed of 35 wpm or higher, with accuracy
- Strong written and verbal communication skills
- Strong listening, interpersonal, and problem-solving skills
- Proficiency with Microsoft Office (Word, Excel, Outlook) and office equipment (printers, scanners, fax, etc.)
- Excellent organization, time management, and attention to detail
- Ability to meet deadlines and work independently or within a team
- Accountability and ability to work cooperatively across departments
- Flexibility to assist with special projects and handle multiple tasks
Now Skills section (Preferred Skills):
- Basic skills in Microsoft PowerPoint
- Bilingual (Ukrainian, Spanish preferred)
- Understanding of health insurance claims, as well as an ability to analyze data to resolve provider service issues
- Experience with benefit administration systems (Bridgeway)
- Experience with Smartsheet or other project management tools
- Remote work experience (laptop provided)
- Experience with virtual conference software (Teams, Zoom)
- Awareness of labor movements, social issues, and political factors impacting the organization
Benefits section: list items.
- Comprehensive health benefits (medical, dental and vision coverage) for employees and eligible dependents, including no employee premium option for employee only
- Competitive compensation
- Generous holidays and PTO policies
- Pension retirement plan
Schedule section: one item maybe.
- Hybrid schedule, averaging 2 scheduled days in-office per week (dependent on department operations and performance)
Now About the role section: combine description and position summary into prose paragraphs.
Description paragraph: "SEIU Healthcare IL Benefit Funds is a dynamic benefits administration organization committed to providing the highest quality health and retirement benefits in the most financially responsible manner, while always acting in the best interest of the union members. The Fund serves over 20,000 union workers in the Nursing Home, Home Care, Childcare and Personal Assistant industries with the delivery of health and pension benefits. Our 50+ employees epitomize the Fund’s core values of quality service, interdependence, effectiveness, and accountability, and forge an alliance with one another to carry out our shared mission and common agreements for those we serve."
Position Summary paragraph: "The Member Service Representative (MSR), Level 1, is a key member of the Member Service call center and outreach teams, providing high-quality service and support to both plan participants and healthcare providers. MSRs ensure that callers consistently receive high-quality customer service that reflects the Benefit Fund Office’s standards, developing trusted member and provider relations with the Fund Office. This role functions within a high-volume call center environment and is responsible for assisting union members and healthcare providers with eligibility, enrollment, benefits, medical claim inquiries and processes, referral requirements, and navigation of the member and provider
- for any list of duties/requirements/benefits. Use
for prose. We need to preserve all substantive information, not invent or summarize away detail. Remove boilerplate: EEO etc. Remove cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, and application instructions. The posting includes EEO statement at end; we should remove that. Also remove "Career Development & Continuing Education Opportunities: Yes" maybe keep? It's substantive? It's a benefit? Could be part of Benefits? It's not a benefit per se but could be included in Benefits? Might be considered a benefit. But we have Benefits section already; we could include that line there. However instruction: include a section ONLY when posting has real, specific content for it — never emit a heading followed by filler/placeholder text. "Career Development & Continuing Education Opportunities: Yes" is specific; we could put under Benefits or maybe a separate section? Not among allowed headings; we could incorporate into Benefits as a bullet. We must not include duplicated lines. Need to extract duties list. Let's parse content: Description paragraph about organization. Position Summary paragraph. Key Duties And Responsibilities: many bullet-like sentences separated by periods. We need to turn into list items. Privacy And Security Responsibilities: paragraph. Requirements: Education Requirements: High school diploma or GED; Customer service certification preferred. Job Requirements: 1–2 years of customer service experience in healthcare (benefits administration preferred); Ability to understand and explain basic enrollment, eligibility, and benefit information; Call center training or experience; Typing speed of 35 wpm or higher, with accuracy; Work a hybrid schedule, averaging 2 scheduled days in-office per week, dependent on department operations and performance; Strong written and verbal communication skills; Strong listening, interpersonal, and problem-solving skills; Proficiency with Microsoft Office (Word, Excel, Outlook) and office equipment (printers, scanners, fax, etc.); Excellent organization, time management, and attention to detail; Ability to meet deadlines and work independently or within a team; Accountability and ability to work cooperatively across departments; Flexibility to assist with special projects and handle multiple tasks. Preferred Skills: Basic skills in Microsoft PowerPoint; Bilingual (Ukrainian, Spanish preferred); Understanding of health insurance claims, as well as an ability to analyze data to resolve provider service issues; Experience with benefit administration systems (Bridgeway); Experience with Smartsheet or other project management tools; Remote work experience (laptop provided); Experience with virtual conference software (Teams, Zoom); Awareness of labor movements, social issues, and political factors impacting the organization. Benefits: SEIU Healthcare IL Benefit Funds offers a comprehensive health benefits (medical, dental and vision coverage) for employees and eligible dependents, including no employee premium option for employee only; competitive compensation; generous holidays and PTO policies; and a pension retirement plan. Schedule: hybrid schedule, averaging 2 scheduled days in-office per week. We need to avoid repeating schedule info in Requirements and also have Schedule section. The schedule is mentioned in Job Requirements; we could keep it there but also have Schedule section. Might be duplicate. Better to move schedule info to Schedule section and remove from Requirements to avoid duplication. However instruction: Preserve ALL substantive information; do NOT invent or summarize away detail. If we remove it from Requirements, we lose that detail unless we keep it elsewhere. We can keep it in both places? That would be duplication. Better to keep it in Schedule section and note that it's also a requirement? But we must preserve all info; we can keep it in Schedule section and also mention in Requirements as part of job requirements? That would be duplicate. The instruction says remove duplicated lines. So we should avoid duplication. So we need to decide where to place schedule info. Since there is a dedicated Schedule section, we can put schedule info there and not duplicate in Requirements. However the Requirements section originally includes schedule as a job requirement; moving it may be considered omitting that detail from Requirements but we still preserve it overall. That's acceptable as we are not losing info, just relocating. The instruction: "Preserve ALL substantive information; do NOT invent or summarize away detail." So as long as we keep the info somewhere, it's fine. Thus we will have Schedule section with that detail. Now we need to format. Sections:
About the role
-> combine description and position summary paragraphs into prose ().
Responsibilities
-> list items from Key Duties And Responsibilities and Privacy And Security Responsibilities. We need to split into list items. Each sentence could be an item. Let's extract sentences: Key Duties And Responsibilities sentences (separated by periods): 1. Professionally handle incoming calls and inquiries from plan participants, medical providers, vendors, and medical partners for all health plans with excellent quality service. 2. Follow scripts, policies, procedures, and plan documents to ensure first -call resolution. 3. Able to perform in a high call volume environment with the ability to provide quality service effectively by phone, in-person, and virtually 4. Resolve any open issues requested from calls, voicemail, and walk-ins while documenting all interactions accurately 5. Provide translation support across departments when needed 6. Meet established call center performance metrics and contribute to improvement initiatives 7. Process enrollments with accurate data entry into the benefits administration system 8. Use project management software (Smartsheet) to track daily requests 9. Have working knowledge on the guidelines of the Fund’s nine (9) health plans while referencing appropriate summary plan descriptions 10. Educate members on eligibility, covered and non-covered services, benefit options, and best practices for healthcare use 11. Provide members and providers with status on claims submission process, medical claim status, benefits, eligibility, member appeal rights, referral requirements and provider reconsiderations 12. Conduct proactive outreach to plan participants to provide education regarding benefits, eligibility requirements, and referral requirements 13. Collaborate with internal departments and healthcare partners to identify members who may benefit from outreach or additional assistance 14. Handle eligibility-related inquiries and disputes by reviewing member records, contributions, and supporting documentation to determine next steps 15. Perform follow-up calls or communications with members to ensure issues have been resolved 16. Track and manage member and provider requests and inquiries 17. Handle network escalations within a 48-hour turnaround time 18. Attend and participate in various meetings, including All Staff meetings, department meetings, training sessions, task force or committee meetings, and other meetings deemed appropriate to share, discuss, and solution for question or error trends, as well as identify potential process improvements 19. Create one-on-one (1:1) agendas with the Member Service Supervisor using the Purpose,Outcome and Process (POP) Model and keeping thorough notes for each meeting Privacy And Security Responsibilities paragraph: "This position requires handling Personally Identifiable Information (PII) and Protected Health Information (PHI). The MSR is responsible for maintaining the confidentiality, integrity, and security of all PII and PHI and must report any suspected identity or HIPAA violations to the HIPAA Privacy and Security Officers." We can split into two items or keep as one paragraph? Since it's prose, we could keep asunder Responsibilities? But instruction: Use
- for any list of duties/requirements/benefits. This is a duty/responsibility, so list item. Could be two items. We'll make two items: - This position requires handling Personally Identifiable Information (PII) and Protected Health Information (PHI). - The MSR is responsible for maintaining the confidentiality, integrity, and security of all PII and PHI and must report any suspected identity or HIPAA violations to the HIPAA Privacy and Security Officers. Now Requirements section: Education Requirements and Job Requirements (excluding schedule). We'll list items. Education Requirements: - High school diploma or GED - Customer service certification preferred Job Requirements (excluding schedule): - 1–2 years of customer service experience in healthcare (benefits administration preferred) - Ability to understand and explain basic enrollment, eligibility, and benefit information - Call center training or experience - Typing speed of 35 wpm or higher, with accuracy - Strong written and verbal communication skills - Strong listening, interpersonal, and problem-solving skills - Proficiency with Microsoft Office (Word, Excel, Outlook) and office equipment (printers, scanners, fax, etc.) - Excellent organization, time management, and attention to detail - Ability to meet deadlines and work independently or within a team - Accountability and ability to work cooperatively across departments - Flexibility to assist with special projects and handle multiple tasks Now Skills section (Preferred Skills): - Basic skills in Microsoft PowerPoint - Bilingual (Ukrainian, Spanish preferred) - Understanding of health insurance claims, as well as an ability to analyze data to resolve provider service issues - Experience with benefit administration systems (Bridgeway) - Experience with Smartsheet or other project management tools - Remote work experience (laptop provided) - Experience with virtual conference software (Teams, Zoom) - Awareness of labor movements, social issues, and political factors impacting the organization Benefits section: list items. - Comprehensive health benefits (medical, dental and vision coverage) for employees and eligible dependents, including no employee premium option for employee only - Competitive compensation - Generous holidays and PTO policies - Pension retirement plan Schedule section: one item maybe. - Hybrid schedule, averaging 2 scheduled days in-office per week (dependent on department operations and performance) Now About the role section: combine description and position summary into prose paragraphs. Description paragraph: "SEIU Healthcare IL Benefit Funds is a dynamic benefits administration organization committed to providing the highest quality health and retirement benefits in the most financially responsible manner, while always acting in the best interest of the union members. The Fund serves over 20,000 union workers in the Nursing Home, Home Care, Childcare and Personal Assistant industries with the delivery of health and pension benefits. Our 50+ employees epitomize the Fund’s core values of quality service, interdependence, effectiveness, and accountability, and forge an alliance with one another to carry out our shared mission and common agreements for those we serve." Position Summary paragraph: "The Member Service Representative (MSR), Level 1, is a key member of the Member Service call center and outreach teams, providing high-quality service and support to both plan participants and healthcare providers. MSRs ensure that callers consistently receive high-quality customer service that reflects the Benefit Fund Office’s standards, developing trusted member and provider relations with the Fund Office. This role functions within a high-volume call center environment and is responsible for assisting union members and healthcare providers with eligibility, enrollment, benefits, medical claim inquiries and processes, referral requirements, and navigation of the member and provider