Member & Provider Support Specialist

Independent Living Systems, llc; Santa Cruz (CA); On-site; USD 25,000 - 39,000; Full time

Job summary

Independent Living Systems (ILS) is seeking a Member & Provider Services Representative to join our Santa Cruz team. You will be a frontline contact for members and providers, handling inbound and outbound calls with empathy, delivering accurate information on health services, scheduling, and inquiries.

The role emphasizes active listening, data accuracy, and adherence to compliance standards to support quality healthcare and social care services for vulnerable populations.

Qualifications

• High School Diploma or GED required.
• Experience in healthcare or related field required.
• Ability to manage high volume call center workloads.
• Strong interpersonal and communication skills.
• Familiarity with data entry and record keeping.

Responsibilities

• Demonstrate commitment to Our Mission and ILS Experience Standards of Excellence.
• Handle a high-volume of inbound/outbound calls, providing accurate information on healthcare services, scheduling, and inquiries in a professional manner.
• Use active listening to identify needs, resolve concerns, educate members and providers, and strive for first call resolution.
• Conduct comprehensive reviews of member and provider inquiries, complaints, grievances, and escalated issues by gathering information and facilitating timely resolution.
• Coordinate with internal departments, providers, and stakeholders to resolve issues and support follow-up needs.
• Manage a high-volume caseload while meeting productivity, SLA, and compliance requirements.
• Accurately document call details, update member records, and utilize systems per procedures.
• Ensure compliance with healthcare regulations and confidentiality standards in all communications.
• Maintain standards for schedule adherence, attendance, quality, and satisfaction metrics.
• Demonstrate professionalism through reliability, teamwork, and ongoing training involvement.
• Perform other duties as assigned.

Skills

Interpersonal communication

Phone etiquette

Data entry

Education

High School Diploma or GED

Associate's degree

Tools

Microsoft Office Suite

Job description

Independent Living Systems (ILS) is seeking a Member & Provider Services Representative to join our Santa Cruz team. You will be a frontline contact for members and providers, handling inbound and outbound calls with empathy, delivering accurate information on health services, scheduling, and inquiries.

The role emphasizes active listening, data accuracy, and adherence to compliance standards to support quality healthcare and social care services for vulnerable populations.