Member Services Advocate – Remote/Hybrid

Group Health Cooperative of South Central WI; Madison (WI); Hybrid; USD 36,000 - 48,000; Full time

Job summary

Group Health Cooperative of South Central Wisconsin is hiring a Member Services Representative to respond to member and provider inquiries about benefits, claims, referrals and clinic services. It includes complaint resolution, data entry, and records maintenance, under the guidance of the Member Services Manager.

The role requires strong communication, confidentiality, and the ability to work independently with multiple projects, with local WI residence and on-site meetings as needed.

Qualifications

• High school education or equivalent required.
• Two years' public contact experience required; healthcare/insurance desirable.
• Ability to learn GHC-SCW benefit plans and clinic operations.
• Proficiency with Microsoft Office and email; EPIC system familiarity encouraged.
• Excellent verbal and written communication and customer service skills.
• Maintain confidentiality and HIPAA knowledge as needed.
• Professional manner with staff, patients, and the public.

Responsibilities

• Respond to members and providers with benefits, claims, referrals, and clinic service inquiries.
• Assist members with complaint resolution, interviewing, investigation, and reporting.
• Perform departmental data entry and file/record maintenance.
• Work under supervision of the Member Services Manager and uphold mission and values.

Skills

Verbal communication

Written communication

Customer service

Multitasking

Time management

Professionalism

Confidentiality

Education

High school diploma or equivalent

Tools

Microsoft Office

EPIC

Job description

Group Health Cooperative of South Central Wisconsin is hiring a Member Services Representative to respond to member and provider inquiries about benefits, claims, referrals and clinic services. It includes complaint resolution, data entry, and records maintenance, under the guidance of the Member Services Manager.

The role requires strong communication, confidentiality, and the ability to work independently with multiple projects, with local WI residence and on-site meetings as needed.