Member Services Representative - Healthcare Benefits & Claims

MMC Group LP; Texas; Presencial; USD 22 000 - 32 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Dental insurance

Health insurance

Vision insurance

Resumo da oferta

MMC Group LP in Houston, TX is seeking a Member Services Representative to be the primary contact for members, providers, and partners, handling benefits, eligibility, claims, and authorizations. This is a fast-paced, on-site healthcare support role offering a 3-month contract with potential extension.

The ideal candidate has a high school diploma, at least 2 years in customer service or call center work, and preferably 1 year in healthcare.

Qualificações

• High school diploma or GED required.
• Minimum 2 years of customer service or call center experience.
• At least 1 year of healthcare-related experience preferred (claims, benefits, eligibility, or authorizations).
• Proficiency in Microsoft Office (Word, Excel, Outlook).
• Strong data entry and computer skills.
• Excellent communication (verbal and written).
• Ability to multitask and work independently in a fast-paced environment.

Responsabilidades

• Handle inbound calls related to member benefits, eligibility, claims status, and authorizations.
• Research and resolve claims inquiries, identifying issues and next steps.
• Submit escalations and reconsideration requests as needed.
• Deliver first-call resolution whenever possible.
• Accurately document all interactions in CRM and case management systems.
• Route inquiries to appropriate departments while maintaining detailed records.
• Identify trends and communicate recurring issues to leadership.
• Ensure compliance with confidentiality and healthcare regulations.
• Collaborate with internal teams to resolve issues efficiently.
• Provide professional, courteous, and solution-focused service.

Conhecimentos

Customer service

Strong communication

Multi-tasking

Data entry

CRM knowledge

Formação académica

High school diploma

Ferramentas

Microsoft Office

Descrição da oferta de emprego

Job Description

Location: Houston, TX 77081 (Onsite)
Pay Rate: $19.69/hour
Start Date: 9/15 , 2026
Assignment Length: 3-month contract (extension possible based on performance and business needs)
Schedule: Monday–Friday, full-time daytime hours
Work Environment: 100% Onsite
Employment Type: Contract / Full-Time

Position Overview

We are seeking a customer-focused and detail-oriented Member Services Representative to join a fast-paced healthcare support team in Houston. In this role, you will serve as the primary point of contact for members, providers, and partners, handling inbound inquiries related to benefits, eligibility, claims, and authorizations.

This is an excellent opportunity for candidates who thrive in high-volume call environments and are passionate about delivering exceptional service while maintaining accuracy and compliance.

Key Responsibilities

• Handle inbound calls related to member benefits, eligibility, claims status, and authorizations
• Research and resolve claims inquiries, identifying issues and next steps
• Submit escalations and reconsideration requests as needed
• Deliver first-call resolution whenever possible
• Accurately document all interactions in CRM and case management systems
• Route inquiries to appropriate departments while maintaining detailed records
• Identify trends and communicate recurring issues to leadership
• Ensure compliance with confidentiality and healthcare regulations
• Collaborate with internal teams to resolve issues efficiently
• Provide professional, courteous, and solution-focused service

Required Qualifications

• High school diploma or GED required
• Minimum 2 years of customer service or call center experience
• At least 1 year of healthcare-related experience preferred (claims, benefits, eligibility, or authorizations)
• Proficiency in Microsoft Office (Word, Excel, Outlook)
• Strong data entry and computer skills
• Excellent communication (verbal and written)
• Ability to multitask and work independently in a fast-paced environment

Preferred Experience

• Healthcare insurance, managed care, or provider support experience
• Familiarity with claims processing and authorization workflows
• Experience using CRM or healthcare service platforms
• Understanding of confidentiality and compliance standards

Core Competencies

• Customer service excellence
• Attention to detail
• Analytical thinking and problem-solving
• Strong communication skills
• Team collaboration
• Accountability and reliability
• Adaptability in fast-paced environments

Why Apply?

• Gain experience in a high-demand healthcare call center environment
• Opportunity for assignment extension or long-term placement
• Work with a collaborative and mission-driven team

Benefits:

• Dental insurance
• Health insurance
• Vision insurance

Application Question(s):

• Do you have 2 years or more call center experience in the last 5 years? (Must be oon resume)
• Do you have at least 1 year of healthcare related experience supporting benefits, claims eligibility, or authorizations? (Must be on resume)

Education:

• High school or equivalent (Required)

Company Description

Throughout the past 30 years plus, MMC, one of the most trusted names in workforce management services, has successfully delivered strategic solutions to large and small businesses in numerous industries.

We have built our reputation on partnering with our clients and candidates to achieve the desired results. Our recruiting professionals have extensive experience matching the right candidate, to the right client, for the right position. We provide the best opportunities to the most talented candidates in a multitude of industries.

MMC is a privately owned business with corporate headquarters in Irving, Texas. With 2,000+ employees, working in 40+ stat