Member Benefits Specialist
Skills
ActingContact CentersFederal RegulationsGEDHealthcareMedical ClaimsNSA
What the job involves
The main requirements, responsibilities and hiring steps.
Requirements
- High school diploma or GED
- 1+ year healthcare industry experience
- Experience in client-focused solutions and direct member contact
- 1+ year telephonic verification of medical benefits preferred
- 2+ years healthcare experience preferred
- Medical claims exposure preferred
- Proficiency in Microsoft Outlook Word and Excel
- Strong written communication skills
- Service-driven mindset
- Advanced soft skills and emotional intelligence
Nice to have
- Service-driven
- Emotional intelligence
- Strong communicator
- Aptitude for learning
- Member-focused
Day to day
- Receive inbound calls from members and provide knowledgeable support on benefit plans and healthcare questions.
- Act as a trusted advocate by researching issues, educating members, and guiding them through benefits and provider interactions.
- Deliver consistent service across phone email and portal channels while maintaining accurate documentation and resolving complaints.