Member Services Representative I

Our client is a Tailored Plan and Managed Care Organization serving 46 counties in North Carolina. They coordinate services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual or developmental disabilities, committed to supporting individuals and families in building strong foundations for healthy, stable, and fulfilling lives.

About the Role

The Member Services Representative I provides front-line customer support to members, providers, and other stakeholders. This role involves responding to inquiries, providing accurate information about benefits and services, connecting callers with appropriate resources, and documenting interactions following established call center procedures.

Responsibilities

• Respond to high-volume inbound calls regarding benefits, services, eligibility, and provider access.
• Provide accurate and timely information to help members understand available services and resources.
• Route callers to appropriate departments, providers, or community resources based on their needs.
• Resolve routine questions, issues, and complaints within established guidelines.
• Document calls, inquiries, actions taken, and outcomes accurately and within required time frames.
• Follow call center procedures, service standards, and confidentiality requirements.
• Maintain professional and compassionate communication with members, providers, and stakeholders.
• Escalate complex or unresolved issues to the appropriate department or supervisor.

Requirements

• High school diploma or GED.
• Minimum of 1 year of experience in a call center, member services, customer service, or a related role; equivalent education and experience may be considered.
• Valid driver’s license.
• Must reside in North Carolina.
• Ability to travel within the service area as required.
• Strong verbal communication, listening, and customer service skills.
• Ability to manage high-volume calls while maintaining accuracy and professionalism.

Preferred Qualifications

• At least 1 year of experience in mental health, substance use, or intellectual/developmental disability services.

Pay

Annual salary range: $36,192–$45,964.

Benefits

• Typical work hours of 8:30 a.m. to 5:00 p.m., with flexible scheduling and work-from-home options for most positions.
• Health insurance with no employee premium for employee-only coverage.
• Flexible Spending Accounts.
• 24 days of paid time off plus 12 paid holidays during the first year.
• North Carolina Local Government Retirement Pension defined-benefit plan.
• 401(k) plan with a 5% employer match and immediate vesting.
• Eligibility for Public Service Loan Forgiveness.
• Quarterly stipend for remote work supplies.