Member Services Specialist (Remote Healthcare Support)

WVU Medicine; United States; Remote; USD 36,000 - 48,000; Full time

Job summary

PHH Peak Health Holdings seeks a Membership Services Representative to handle inbound member calls, resolve issues, and support outbound outreach for issue resolution. This role emphasizes accurate information, effective communication, and adherence to policies while contributing to a seamless member experience.

Candidates should have a high school diploma or GED, 2+ years in a call center, and healthcare or insurance knowledge.

Qualifications

• High School diploma or GED required.
• Two years customer service in a call center.
• Associate degree in healthcare preferred.
• Two+ years in fast-paced call environment.
• Experience with medical insurance processes is a plus.

Responsibilities

• Verify member information and answer general questions.
• Respond to and resolve member inquiries for a seamless experience.
• Maintain open member communications and outreach as needed.
• Meet production and quality standards and manage work queues.
• Communicate with internal/external staff.
• Escalate issues to supervision when appropriate.
• Attend trainings and maintain documentation.
• Maintain timekeeping records.

Skills

Customer service

Call center experience

Healthcare knowledge

Communication skills

Problem solving

Education

High School diploma/GED

Associate Degree in healthcare

Tools

Epic Systems

Microsoft Office

Outlook

Excel

Job description

PHH Peak Health Holdings seeks a Membership Services Representative to handle inbound member calls, resolve issues, and support outbound outreach for issue resolution. This role emphasizes accurate information, effective communication, and adherence to policies while contributing to a seamless member experience.

Candidates should have a high school diploma or GED, 2+ years in a call center, and healthcare or insurance knowledge.