Member Services Representative

Siho Holding; Columbus (IN); On-site; USD 32,000 - 42,000; Full time

Job summary

SIHO Holding seeks a dedicated Member Services Representative in Columbus, IN. The role primarily handles member and provider inquiries via phone, with some written correspondence and walk-in support.

You will be part of a team focused on delivering excellent customer experiences in a healthcare setting. Responsibilities include guiding members through benefits, resolving claim questions, and coordinating with other departments to address concerns.

Qualifications

• Passion for customer service
• Strong verbal and written communication skills
• Healthcare knowledge preferred but not required

Responsibilities

• Assist members with navigating healthcare needs and explaining benefits
• Address inquiries via telephone; respond to written inquiries as needed
• Record details of inquiries, comments, complaints and transactions
• Escalate unresolved grievances to appropriate channels
• Collaborate with other departments and providers to resolve member concerns
• Aim for first call resolution and proactive issue resolution
• Support teammates to meet department and company goals
• Perform other duties as assigned

Skills

Customer service

Excellent communication

Active listening

Healthcare knowledge

Emotional intelligence

Job description

Job Details

Job Location: 417 Washington Street - Columbus, IN 47201

Travel Percentage: No Travel

Job Category: Insurance

Job Title: Member Services Representative

Reports To: Manager, Member Services

Locations: Columbus, IN

**Not open to remote candidates at this time

SIHO’s Member Services Representatives assist in creating an excellent experience for SIHO’s members and their providers. The primary responsibility of this position is to respond to member’s and providers inquiries. This position mainly responds to telephonic inquiries but may also be responsible for responding to written inquiries and assisting walk-in members. This is a non-exempt position reporting to the Manager of Member Services.

Brief Description of Duties

• Assist members with navigating their healthcare needs by explaining benefits, solving claim concerns, finding a doctor nearby or being their healthcare advocate
• Comply with regulatory requirements while addressing customer needs which may include complex benefit questions.
• Record details of inquiries, comments, complaints, and transactions.
• Escalate unresolved and pending customer grievances.
• Support teammates as business needs require to ensure the organization is meeting the needs of our members and providers
• Strive for first call resolution while demonstrating SIHO’s dedication to proactively work to resolve members questions and concerns.
• Work with partners in other departments, or to Doctors’ offices to help resolve a customer concern.
• Support your teammates as business needs require to ensure we are meeting the needs of our customers.
• Performs other relevant duties deemed necessary to achieve department and company-wide goals.

Traits we are looking for

• Trustworthy
• Empathic
• Proactive
• Compassionate
• Good Listener
• Problem Solver
• Communicator
• Patient
• Personable & Collaborative

Minimum Skills Requirement

• Possess a passion for customer service
• Excellent communications (oral and written) and strong listening skills
• Experience in healthcare is preferred, but not required
• General knowledge and understanding of health insurance
• This job calls for strong emotional intelligence to proactively provide solutions, ensuring the member's health and safety
• Ability to maintain attendance to support required quality and quantity of work