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 provide exceptional support to members, customers, and providers. This role emphasizes effective communication and problem-solving skills in a fully remote environment. You will be responsible for addressing inquiries related to coverage, claims, and billing while ensuring timely responses to meet departmental metrics. Join a dynamic team dedicated to improving member experiences and contributing to the healthcare industry. This is an excellent opportunity for individuals with a passion for customer service and a desire to make a positive impact.

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 (PTO, Vacation or Sick Leave)

Qualifications

• Proficient in Medicare or Group/Marketplace, translating healthcare jargon.
• Experience in a customer service focused industry strongly desired.

Responsibilities

• Answer phone and email inquiries on coverage, claims, and billing.
• Document interactions and follow-up actions in the database.

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

• 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.
• Proficient in one line of business, either Medicare or Group/Marketplace, translating health care related jargon into effective written or verbal communication for the end user to comprehend.
• Document details of the interaction within the database, including any additional action steps taken as follow up.
• Answer incoming phone calls from members, customers, providers or brokers efficiently regarding their inquiries on coverage, claim status, benefit interpretation, billing and/or authorizations.
• Respond to inquiries within set timeframes to adhere to department metrics and contractual standards.
  
  
  

Description

• 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.
• Proficient in one line of business, either Medicare or Group/Marketplace, translating health care related jargon into effective written or verbal communication for the end user to comprehend.
• Document details of the interaction within the database, including any additional action steps taken as follow up.
• Answer incoming phone calls from members, customers, providers or brokers efficiently regarding their inquiries on coverage, claim status, benefit interpretation, billing and/or authorizations.
• 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 - $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

subject to specific elections, plan, or program terms. If eligible, the benefits

Available For This Temporary Role May Include The Following

• 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 the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)
  
  
  

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on May 20, 2025.

About TEKsystems And TEKsystems Global Services

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider 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.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  IT Services and IT Consulting

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