Member Care Advocate: Benefits, Claims & Support

SIHO Insurance Services; Columbus (IN); On-site; USD 36,000 - 48,000; Full time

Benefits offered by this job

Job summary

SIHO Insurance Services is seeking a Member Services Representative in Columbus, IN. The role focuses on responding to member and provider inquiries, primarily by phone, with some written communication and walk-in assistance.

This non-exempt, on-site position reports to the Manager of Member Services. Responsibilities include guiding members through benefits, resolving claim concerns, and coordinating with providers to resolve issues.

Qualifications

• Passion for customer service.
• Excellent oral and written communication; strong listening skills.
• General knowledge of health insurance.
• Ability to maintain reliable attendance to meet quality and quantity targets.

Responsibilities

• Respond to member and provider inquiries via telephone and written channels.
• Assist members with navigating benefits and resolving claim concerns.
• Locate doctors or providers and advocate for members’ healthcare needs.
• Record inquiry details, comments, complaints, and transactions.
• Escalate unresolved or pending customer grievances.
• Collaborate with other departments and providers to resolve issues.
• Aim for first-call resolution and proactive problem solving.
• Perform other duties to support team and company goals.

Skills

Customer service

Communication skills

Active listening

Empathy

Emotional intelligence

Attendance

Job description

SIHO Insurance Services is seeking a Member Services Representative in Columbus, IN. The role focuses on responding to member and provider inquiries, primarily by phone, with some written communication and walk-in assistance.

This non-exempt, on-site position reports to the Manager of Member Services. Responsibilities include guiding members through benefits, resolving claim concerns, and coordinating with providers to resolve issues.