Member Services Specialist: Healthcare Support & Resolution

Sigma Systems, Inc.; Irving (TX); On-site; USD 21,000 - 30,000; Full time

Job summary

Sigma Inc. seeks a Member Services Representative to provide high-quality support to health plan members, providers, and brokers in person at our Irving, TX location. This frontline role emphasizes first-call resolution, navigation of health plan offerings, and clear communication.

Responsibilities include handling inquiries across Health Exchange, US Family Health Plan, and NCHD, documenting interactions in CRM, and guiding members through portals. Overtime may be required during peak periods.

Qualifications

• High school diploma or GED required.
• 2+ years in customer service in healthcare, insurance, or call center.
• Strong verbal and written communication; professional presentation.
• Ability to multitask in a fast-paced, metric-driven environment.
• Attention to detail and accurate documentation.
• Proficient with Microsoft Office; quick to learn proprietary systems.
• Team-oriented with a customer-first mindset; empathetic and patient.
• Willingness to work overtime during peak periods.
• Ability to work remotely on scheduled days with reliable internet.

Responsibilities

• Meet competencies for self, team, or leaders as applicable.
• Resolve inquiries for members, providers, or brokers across health plans.
• Handle routine inquiries with scripting, navigation, and documentation.
• Document calls clearly in CRM for audit readiness and coordination.
• Explain benefits and eligibility; assist members with coverage access.
• Guide members through CHRISTUS website and member portal navigation.
• Redirect providers to approved electronic channels for eligibility and claims.
• Maintain performance metrics such as calls, handle time, hold time, and schedule adherence.
• Advocate for beneficiaries to resolve issues with care.
• Support projects and team goals under leadership direction.

Skills

Customer service

Healthcare experience

Communication

Multitasking

Attention to detail

Team collaboration

Empathy

Problem solving

Overtime availability

Remote work familiarity

Education

High school diploma or GED

Tools

Microsoft Office

Job description

Sigma Inc. seeks a Member Services Representative to provide high-quality support to health plan members, providers, and brokers in person at our Irving, TX location. This frontline role emphasizes first-call resolution, navigation of health plan offerings, and clear communication.

Responsibilities include handling inquiries across Health Exchange, US Family Health Plan, and NCHD, documenting interactions in CRM, and guiding members through portals. Overtime may be required during peak periods.