Member Service Specialist

About the role

The Member Service Specialist serves as a primary point of contact for members and providers while also providing essential back end and administrative support to ensure timely and accurate resolution of inquiries.

Responsibilities

• Answers inbound calls, manages shared inboxes, completes follow-up work, conducts research, and performs outbound communications.
• Collaborates closely with internal teams to achieve first call resolution whenever possible and ensures seamless handling of ongoing or complex requests.
• Documents all calls, actions, and resolutions in call tracking and case management systems.
• Manages and responds to inquiries in shared and assigned inboxes promptly, professionally, and with empathy.
• Completes follow-up work and administrative tasks to support member and provider requests.
• Conducts research and performs outbound communications to resolve inquiries.
• Takes ownership of assigned and claimed tasks to ensure timely completion.
• Communicates follow-up needs clearly and collaborates across teams as required.
• Takes phone coverage during periods of high call volume or operational need.
• Identifies and communicates trends, recurring issues, and process improvement opportunities to leadership.
• Adopts innovative technology, including proprietary AI solutions, into the service process to deliver a best-in-class client service experience.
• Performs other projects, duties, and tasks, as assigned.

Requirements

• High school diploma or equivalent required.
• Previous customer service experience, preferably in a call center, healthcare, insurance, or administrative support environment.
• Experience in member services, healthcare, or insurance operations preferred.
• Familiarity with shared inboxes, ticketing systems, call tracking, or CRM/case management systems preferred.
• Experience documenting work in CRM or case management platforms preferred.
• Prior experience working in a team-based support environment preferred.
• Strong verbal and written communication skills.
• Able to multitask, prioritize, and meet response-time expectations in a fast-paced setting.
• High attention to detail and documentation accuracy.
• Professional demeanor with strong interpersonal, collaboration, and time management skills.
• Basic computer proficiency and ability to learn new systems.

Qualifications

• Competitive pay.
• A safe and healthy work environment provided by our robust benefit program including family health and wellness programs, 401K, employee assistance programs, paid time off, paid holidays and more.
• Career advancement and development opportunities.

Skills

• Customer service skills.
• Call center experience.
• Healthcare or insurance operations experience.
• Shared inbox management.
• CRM/case management system experience.
• Outbound communication skills.
• Research and problem-solving abilities.
• Team collaboration and communication skills.
• Time management and multitasking abilities.
• Attention to detail.
• Computer proficiency.

Benefits

• Competitive pay.
• A safe and healthy work environment provided by our robust benefit program including family health and wellness programs, 401K, employee assistance programs, paid time off, paid holidays and more.
• Career advancement and development opportunities.

Pay

• $15.54 - $33.65

Schedule

• Flexible schedule to accommodate call volume and operational needs.