Healthcare Insurance Specialist

TEKsystems; Milwaukee (WI); Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking a Member Experience Representative to enhance customer interactions through effective communication. This role focuses on addressing inquiries related to coverage, claims, and benefits while ensuring compliance with departmental standards. The ideal candidate will possess a strong background in healthcare insurance and customer service, demonstrating the ability to translate complex information into understandable terms. Join a dynamic team that prioritizes customer satisfaction and benefits from a fully remote work environment, along with comprehensive medical and retirement plans.

Benefits

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Short and long-term disability

Health Spending Account (HSA)

Transportation benefits

Employee Assistance Program

Time Off/Leave

Qualifications

• 1-3 years of healthcare insurance experience required.
• Experience in customer service-focused industry preferred.

Responsibilities

• Answer phone or email inquiries regarding coverage and claims.
• Document interactions and follow-up actions in the database.
• Respond to inquiries within set timeframes to meet metrics.

Skills

Customer service

Insurance

Medicare

Group insurance

Managed Care

Health Plan

Data entry

Claim

Microsoft Office

Education

1-3 years of Healthcare insurance experience

Job description

Description

1. The Member Experience Representative's primary focus is to answer phone or email inquiries from providers, members, customers, or brokers regarding questions of coverage, claim status, benefit interpretation, billing, and/or authorizations.
2. Proficient in one line of business, either Medicare or Group/Marketplace, translating healthcare-related jargon into effective written or verbal communication for the end user to comprehend.
3. Document details of interactions within the database, including any additional action steps taken as follow-up.
4. Answer incoming phone calls efficiently regarding inquiries on coverage, claim status, benefit interpretation, billing, and/or authorizations.
5. Respond to inquiries within set timeframes to adhere to department metrics and contractual standards.

Skills

Customer service, insurance, Medicare, group insurance, Managed Care, Health Plan, Data entry, Claim, Microsoft Office

Additional Skills & Qualifications

• 1-3 years of Healthcare insurance experience
• Experience working in a customer service-focused industry strongly desired.
• Experience working in a call center preferred.
• Knowledge of basic insurance concepts preferred.

Pay and Benefits

The pay range for this position is $18.25/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be specific to elections, plan, or program terms. If eligible, benefits may include:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation, Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

Anticipated closing date is May 20, 2025.

About TEKsystems and TEKsystems Global Services

We are a leading provider of business and technology services, accelerating business transformation for our customers through strategy, design, execution, and operations. With a team of 80,000, we work with over 6,000 customers, including 80% of the Fortune 500, across North America, Europe, and Asia. We are committed to building tomorrow by delivering business outcomes and making positive impacts in our communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and considers all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information, or any characteristic protected by law.