Healthcare Claims & Member Services Specialist

Insight Global; Birmingham (AL); On-site; USD 22,000 - 30,000; Full time

Job summary

Insight Global is assisting a client in finding a Claims & Member Services Representative to join a growing healthcare benefits organization located in Birmingham, AL. This individual will serve as a key point of contact for members and healthcare providers, assisting with insurance claims, eligibility questions, benefit inquiries, payment status, and portal support.

This is a fast-paced, customer-focused role that requires strong communication skills, the ability to manage a high volume of

Qualifications

• Experience in customer service, ideally retail or call center.
• Strong phone presence handling high call volumes.
• Ability to manage priorities across phone, email, and workflows.
• Proficiency with Microsoft Office and navigating multiple systems.
• Quick learner with ability to multi-task.

Responsibilities

• Handle a high volume of inbound calls and emails from members and providers.
• Assist with benefit inquiries, claims questions, reimbursements, and portal issues.
• Support providers with claim status, eligibility, and benefits information.
• Research and resolve claims issues using multiple systems.
• Escalate complex claims with internal teams.
• Update provider and member information for accurate processing.
• Partner with Provider Relations to resolve filing issues.
• Document interactions and maintain accurate records.
• Use tools/databases to investigate insurance and claims inquiries.

Skills

Customer service

Phone support

Multitasking

Microsoft Office

Organizational skills

Problem solving

Communication skills

Call center experience

Tools

CRM systems

Job description

Insight Global is assisting a client in finding a Claims & Member Services Representative to join a growing healthcare benefits organization located in Birmingham, AL. This individual will serve as a key point of contact for members and healthcare providers, assisting with insurance claims, eligibility questions, benefit inquiries, payment status, and portal support.

This is a fast-paced, customer-focused role that requires strong communication skills, the ability to manage a high volume of