Healthcare Member Services Specialist - Onsite

MMC Group LP; Texas; On-site; USD 22,000 - 32,000; Full time

Benefits offered by this job

Dental insurance

Health insurance

Vision insurance

Job summary

MMC Group LP in Houston, TX is seeking a Member Services Representative to be the primary contact for members, providers, and partners, handling benefits, eligibility, claims, and authorizations. This is a fast-paced, on-site healthcare support role offering a 3-month contract with potential extension.

The ideal candidate has a high school diploma, at least 2 years in customer service or call center work, and preferably 1 year in healthcare.

Qualifications

• High school diploma or GED required.
• Minimum 2 years of customer service or call center experience.
• At least 1 year of healthcare-related experience preferred (claims, benefits, eligibility, or authorizations).
• Proficiency in Microsoft Office (Word, Excel, Outlook).
• Strong data entry and computer skills.
• Excellent communication (verbal and written).
• Ability to multitask and work independently in a fast-paced environment.

Responsibilities

• Handle inbound calls related to member benefits, eligibility, claims status, and authorizations.
• Research and resolve claims inquiries, identifying issues and next steps.
• Submit escalations and reconsideration requests as needed.
• Deliver first-call resolution whenever possible.
• Accurately document all interactions in CRM and case management systems.
• Route inquiries to appropriate departments while maintaining detailed records.
• Identify trends and communicate recurring issues to leadership.
• Ensure compliance with confidentiality and healthcare regulations.
• Collaborate with internal teams to resolve issues efficiently.
• Provide professional, courteous, and solution-focused service.

Skills

Customer service

Strong communication

Multi-tasking

Data entry

CRM knowledge

Education

High school diploma

Tools

Microsoft Office

Job description

MMC Group LP in Houston, TX is seeking a Member Services Representative to be the primary contact for members, providers, and partners, handling benefits, eligibility, claims, and authorizations. This is a fast-paced, on-site healthcare support role offering a 3-month contract with potential extension.

The ideal candidate has a high school diploma, at least 2 years in customer service or call center work, and preferably 1 year in healthcare.