Member Experience Representative - Onsite

Beacon Hill; Dublin (OH); On-site; USD 25,000 - 29,000; Full time

Job summary

Beacon Hill's client in Dublin, OH is seeking a Member Experience Representative to provide expert assistance on healthcare coverage, claims, and benefit-related inquiries. This onsite role emphasizes empathetic, problem-solving customer support for members navigating complex medical information.

After paid onsite training (7 weeks, 9am-6pm EST, Mon-Fri), the schedule becomes Monday-Friday, 10:00 AM - 7:00 PM EST. Candidates should excel in communication and have a professional phone presence.

Qualifications

• High School Diploma or GED required.

Responsibilities

• Handle member communications related to healthcare benefits, eligibility, claims, provider networks, billing questions, and authorization requests.
• Explain healthcare plans and coverage details clearly to members.
• Research member concerns and collaborate with providers, insurers, and internal teams to resolve issues.
• Assist members with understanding costs, coverage determinations, and benefit utilization.
• Support authorization and approval processes with timely updates and proper documentation.
• Review and investigate claims inquiries and follow up on unresolved issues.
• Advocate for members by facilitating communication between providers and insurers when needed.
• Identify ways to improve the member journey through education and proactive outreach.

Skills

Customer service

Communication

Empathy

Problem solving

Phone presence

Education

High School Diploma or GED

Tools

Microsoft Outlook

Microsoft Word

Microsoft Excel

PowerPoint

Teams

Job description

Member Experience Representative - Onsite (12097485) Dublin, Ohio

Salary: USD18.5 - USD18.5 per hour

Member Experience Representative
Contract-to-Hire | Full-Time | 100% Onsite
Location: Northern Columbus Area, OH

Beacon Hill's client is seeking service-driven professionals to join their team as Member Experience Representatives. This opportunity is perfect for individuals who enjoy helping others, resolving challenges, and delivering outstanding customer support in a healthcare-focused environment.

Position Summary

As a Member Experience Representative, you will be a trusted resource for individuals seeking assistance with healthcare coverage, claims, provider services, authorizations, and benefit-related questions. You will provide guidance, education, and support while helping members navigate complex situations and access the information they need to make confident healthcare decisions.

This role is ideal for compassionate professionals who thrive in a customer-focused setting, enjoy problem-solving, and are committed to creating positive experiences for every member interaction.

Schedule

After Training:

• Monday-Friday
• 10:00 AM - 7:00 PM EST

Training Period:

• 7 weeks of paid onsite training
• Monday-Friday
• 9:00 AM - 6:00 PM EST

Key Responsibilities

• Handle incoming and outgoing member communications related to healthcare benefits, eligibility, claims, provider networks, billing questions, and authorization requests.
• Explain healthcare plans, coverage details, and available services in a clear and easy-to-understand manner.
• Research member concerns, gather necessary information, and collaborate with providers, insurance partners, and internal teams to achieve resolutions.
• Assist members with understanding healthcare costs, coverage determinations, and benefit utilization.
• Support authorization and approval processes by providing updates and ensuring documentation requirements are met.
• Review and investigate claims inquiries while proactively following through on unresolved issues.
• Advocate for members by helping facilitate communication between healthcare providers and insurance organizations when challenges arise.
• Identify opportunities to improve the member journey through education, proactive outreach, and personalized assistance.
• Accurately document interactions and case activities while working across multiple software platforms.
• Provide professional and compassionate service during sensitive healthcare-related conversations.

Required Qualifications

• Strong customer service and communication skills.
• High School Diploma or GED required.
• Ability to demonstrate empathy and build rapport with customers.
• Effective problem-solving and critical-thinking abilities.
• Professional phone presence and excellent verbal communication skills.
• Reliable attendance and strong accountability.
• Proficiency with Microsoft Outlook, Word, Excel, PowerPoint, and Teams.

Beacon Hill offers eligible employees access to comprehensive benefits programs, including medical, dental, vision, and applicable federal and state leave benefits. Additional details regarding benefit offerings will be provided upon hire.