Member Service Representative

Insight Global; Birmingham (AL); On-site; USD 22,000 - 30,000; Full time

Job summary

Insight Global is assisting a client in finding a Claims & Member Services Representative to join a growing healthcare benefits organization located in Birmingham, AL. This individual will serve as a key point of contact for members and healthcare providers, assisting with insurance claims, eligibility questions, benefit inquiries, payment status, and portal support.

This is a fast-paced, customer-focused role that requires strong communication skills, the ability to manage a high volume of

Qualifications

• Experience in customer service, ideally retail or call center.
• Strong phone presence handling high call volumes.
• Ability to manage priorities across phone, email, and workflows.
• Proficiency with Microsoft Office and navigating multiple systems.
• Quick learner with ability to multi-task.

Responsibilities

• Handle a high volume of inbound calls and emails from members and providers.
• Assist with benefit inquiries, claims questions, reimbursements, and portal issues.
• Support providers with claim status, eligibility, and benefits information.
• Research and resolve claims issues using multiple systems.
• Escalate complex claims with internal teams.
• Update provider and member information for accurate processing.
• Partner with Provider Relations to resolve filing issues.
• Document interactions and maintain accurate records.
• Use tools/databases to investigate insurance and claims inquiries.

Skills

Customer service

Phone support

Multitasking

Microsoft Office

Organizational skills

Problem solving

Communication skills

Call center experience

Tools

CRM systems

Job description

Open to candidates with retail or customer service backgrounds open to growing skills in insurance claims!

Requirements

• Experience in customer service, ideally retail or call center
• Strong phone presence with the ability to confidently handle high call volumes and challenging conversations.
• Ability to manage multiple priorities across phone, email, and system-based workflows.
• Strong problem-solving, organizational, and communication skills.
• Proficiency with Microsoft Office and navigating multiple systems simultaneously.
• Quick learner with the ability to multi-task

Plusses

• Experience working for a health insurance carrier, third-party administrator, physician practice, hospital, or revenue cycle organization.
• Knowledge of claim adjudication, payment processing, and provider relations workflows.
• Familiarity with healthcare systems, claim management platforms, or insurance support tools.
• Minimum 1 year of experience in a healthcare insurance, claims processing, revenue cycle, medical billing, or related environment.
• Understanding of healthcare insurance claims, eligibility verification, benefits, and reimbursement processes.
• Experience working with providers, patients, members, or healthcare organizations.
• Strong phone presence with the ability to confidently handle high call volumes and challenging conversations.

Responsibilities

Insight Global is assisting a client in finding a Claims & Member Services Representative to join a growing healthcare benefits organization located in Birmingham, AL. This individual will serve as a key point of contact for members and healthcare providers, assisting with insurance claims, eligibility questions, benefit inquiries, payment status, and portal support.

This is a fast-paced, customer-focused role that requires strong communication skills, the ability to manage a high volume of calls and emails, and a solid understanding of healthcare insurance and claims processes.

• Handle a high volume of inbound calls, emails, and other correspondence from members and healthcare providers.
• Assist members with benefit inquiries, claims questions, reimbursement requests, and portal-related issues.
• Support providers with claim status requests, payment inquiries, eligibility verification, and benefits information.
• Research and resolve claims-related issues using multiple systems and internal resources.
• Coordinate with internal teams to **escalate** claims requiring review, reprocessing, or additional analysis.
• Update provider and member information as needed to ensure accurate claim processing and payment delivery.
• Partner with Provider Relations to resolve provider filing and claim submission issues.
• Respond to inquiries professionally and efficiently while maintaining a high level of customer service.
• Document interactions and maintain accurate records within company systems.
• Utilize tools and databases to investigate and resolve complex insurance and claims inquiries.