Call Center Representative (Member Services) - USFHP

Pacific Medical Centers; Renton (WA); On-site; USD 30,000 - 48,000; Full time

Benefits offered by this job

Comprehensive benefits

Job summary

Pacific Medical Centers is seeking a Member Services Representative in Renton, WA to serve as a trusted resource for military families and other members within US Family Health Plan. You will handle benefits, eligibility, referrals, claims, billing, and access to care via phone, email, and written correspondence.

In this frontline role, you will manage high volumes with accuracy and empathy, guide members through complaint and appeals processes, and collaborate with clinics and internal teams to

Qualifications

• 2 years of experience in healthcare field customer service.
• Post secondary education preferred.
• Call Center experience in healthcare setting preferred.

Responsibilities

• Respond to member and provider inquiries about benefits, eligibility, referrals, claims, and billing.
• Assist with appointment access and coverage options via phone and written channels.
• Guide members through complaint, grievance and appeals processes.
• Document interactions and track follow-ups in the system.

Skills

Healthcare experience

Call Center Experience

Education

Post secondary education

Job description

Description

Be the voice our heroes trust when they need help.

At PacMed’s US Family Health Plan (USFHP), every interaction matters. As a Member Services Representative, you will serve as a trusted resource for uniformed service members, retirees, and their families, helping them understand their benefits, navigate the healthcare system, and resolve concerns with professionalism, empathy, and accuracy.

In this frontline role, you will assist members and providers with questions about benefits, eligibility, referrals, claims, billing, appointment access, and coverage options. Using an automated call distribution (ACD) system, you will manage a high volume of inbound inquiries while delivering timely, accurate service through phone, written, and electronic communication channels. You will also process correspondence, respond to written inquiries, and document interactions to ensure effective tracking and follow-up.

Success in this position requires strong customer service skills, critical thinking, and the ability to prioritize tasks while working independently. You will guide members through complaint, grievance, and appeals processes, help new enrollees understand their coverage, and collaborate with providers, clinics, and internal teams to support positive outcomes. Strong communication skills, attention to detail, and a calm, solution-focused approach are essential.

Experience with health insurance, managed care, medical terminology, or TRICARE benefits is helpful, but equally important is a commitment to delivering exceptional service with compassion and respect.

Required qualifications:

• 2 years of experience in healthcare field customer service position.

Preferred qualifications:

• Post secondary education.
• 2 years of experience in healthcare field customer service position in an HMO setting.
• Call Center Experience

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our mission to advocate, educate and provide extraordinary care.

Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.
Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Pacific Medical Centers (PacMed) is a private, not-for-profit, primary and integrated multi-specialty health care network with outpatient clinics and primary and specialty care providers in King, Snohomish and Pierce counties. We combine decades of patient-centered care with cutting-edge technology, first-class facilities and board-certified providers.

Our strong team environment and respect for our people—at all levels and from all backgrounds—allow us to provide authentic care that achieves the highest-quality patient outcomes, backed by the strong network of resources and support through our affiliation with the Providence family, including local partners like Swedish Health Services.

For any concerns with this posting relating to the posting requirements in RCW 49.58.110(1), click here where you can access an email link to submit your concern.

Job Category: Member Services Enrollment & Billing

Job Function: Health Plans Services

Job Schedule: Full time

Job Shift: Multiple shifts available

Career Track: Admin Support

Department: 3060 WA USFHP

Address: WA Renton 620 Naches Ave SW

Work Location: Blackriver Corporate Park-Renton

Workplace Type: On-site

Pay Range: $22.62 - $35.22

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.