Member Service Representative

LHH; Sacramento (CA); Hybrid; USD 42,000 - 62,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

Short-term disability

401K plan

Commuter benefits

Employee assistance program

Job summary

LHH is seeking a friendly Member Services Representative to support health plan members, providers, and brokers in a fast-paced call center. You will answer questions about benefits and claims, research concerns, and collaborate with internal teams to ensure accurate, timely support.

This hybrid role requires a High School Diploma and at least 2 years in healthcare call center environments; bilingual candidates are encouraged.

Qualifications

• At least 2 years of call center experience in healthcare or health insurance.
• Comfortable in a fast-paced environment with high volume.
• Bilingual candidates are encouraged to apply (English plus another language).

Responsibilities

• Assist members and providers with questions about benefits, claims, policies, and procedures.
• Research and resolve member concerns, including time-sensitive issues.
• Help with claims and billing questions.
• Document and refer appeals and grievances accurately.
• Educate members on referral programs and self-service tools.
• Collaborate with internal teams to resolve issues within timeframes.
• Provide calm, professional support during difficult interactions.

Skills

Call center experience

Healthcare knowledge

Bilingual

Basic computer skills

Education

High School Diploma or equivalent

Tools

Salesforce

Genesis

Job description

Schedule

7-day operation | Shifts may start as early as 7:00 AM and end as late as 8:00 PM

Hybrid Opportunity

Eligible for hybrid work based on performance

We’re looking for a friendly, dependable Member Services Representative who enjoys helping others and thrives in a fast-paced call center environment.

In this role, you’ll be a key point of contact for health plan members, healthcare providers, and brokers, helping answer questions about benefits, claims, policies, referrals, and services. You’ll research concerns, find solutions, and work with internal teams to make sure members receive accurate and timely support.

What You’ll Do

• Assist members and providers with questions about health plan benefits, claims, policies, and procedures.
• Research and resolve member concerns, including time-sensitive or urgent issues.
• Help with claims and billing-related questions.
• Accurately document and refer appeals and grievances.
• Educate members on referral programs, online resources, and self-service tools.
• Partner with internal departments to resolve issues within required timeframes.
• Provide calm, professional support during difficult or emotional customer interactions.
• Document interactions accurately and elevate system or service concerns when necessary.
• High School Diploma or equivalent.
• Minimum 2 years of call center experience in Healthcare, health insurance, or HMO experience required.
• Comfortable working in a fast-paced, high-volume environment.
• Basic computer proficiency and ability to learn multiple systems and databases.
• Experience with systems such as Salesforce or Genesis is a plus.
• Bilingual candidates are encouraged to apply!

Benefits include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, an EAP program, commuter benefits, and a 401K plan. Our program allows employees to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.

Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable: