Member Services Specialist

SGS Consulting; Clifton (TX); On-site; USD 36,000 - 48,000; Full time

Job summary

SGS Consulting is seeking a healthcare customer service agent to assist members by phone, email, and chat, answering questions about benefits, claims, and coverage. You will document interactions accurately and adhere to service standards.

In this role you will collaborate with internal teams to deliver a seamless member experience, with emphasis on clear communication, first-call resolution, and high-quality service. A high school diploma is required, with prior CRM experience preferred.

Qualifications

• Clear communication and empathy when explaining benefits, claims, and coverage.
• Ability to document interactions accurately and adhere to service standards.
• Experience with CRM systems or healthcare platforms is a plus.

Responsibilities

• Respond to member inquiries via phone, email, and chat regarding benefits, claims, and coverage.
• Resolve issues promptly while ensuring accurate documentation and adherence to service standards.
• Collaborate with internal teams to deliver a seamless and informed member experience.

Skills

Strong communication

Customer service

CRM proficiency

Healthcare platforms

Education

High School Diploma

Tools

CRM Systems

Job description

Job Responsibilities:

• Respond to member inquiries via phone, email, and chat regarding benefits, claims, and coverage.
• Resolve issues promptly while ensuring accurate documentation and adherence to service standards.
• Collaborate with internal teams to deliver a seamless and informed member experience.

Skills:

• Strong communication and customer service skills with the ability to explain complex healthcare information clearly.
• Proficient in using CRM systems and navigating healthcare platforms like HSP, HPS, and HealthTrio.
• Detail-oriented, with problem-solving abilities and a focus on first-call resolution and service quality.

Education/Experience:

• High School Diploma