Onsite Healthcare Member Services Specialist

MMC Group LP; Texas; On-site; USD 22,000 - 32,000; Full time

Job summary

MMC Group LP in Houston, Texas is seeking a Member Services Representative - Healthcare Support Specialist to join a fast-paced, on-site call center. The 3-month contract provides daytime, full-time hours with a pay rate of $19.69 per hour and potential extension based on performance.

The role handles inquiries related to healthcare benefits, eligibility, claims, and authorizations, ensuring accurate documentation and first-call resolution where possible.

Qualifications

• HS diploma or GED required.
• Minimum of 2 years of customer service or call center experience.
• At least 1 year of healthcare-related experience supporting benefits, claims, eligibility, or authorizations preferred.
• Strong working knowledge of Microsoft Office including Word, Excel, and Outlook.
• Ability to work independently with minimal supervision.
• Strong data entry accuracy and moderate to advanced computer proficiency.
• Excellent written and verbal communication skills.
• Strong problem-solving ability with attention to detail.
• Ability to manage multiple priorities in a fast-paced environment.

Responsibilities

• Manage incoming calls related to member benefits, eligibility verification, claim status updates, prior authorizations, and service concerns.
• Research and resolve claims-related inquiries by identifying issues, reviewing claim details, and determining appropriate next steps.
• Submit reconsideration requests and escalation documentation when necessary.
• Provide first-call resolution whenever possible to ensure a positive customer experience.
• Accurately document all interactions, updates, and follow-up actions within internal CRM and case management systems.
• Route inquiries electronically to the appropriate departments while maintaining complete and accurate records.
• Track recurring issues and communicate trends to leadership for operational improvements.
• Maintain compliance with privacy standards, confidentiality requirements, and internal service protocols.
• Collaborate with internal teams including claims, eligibility, authorizations, and operations support to ensure timely issue resolution.
• Deliver professional, courteous, and solution-focused service in every interaction.

Skills

Customer service

Data entry

Microsoft Office

Written communication

Verbal communication

Multitasking

Independent work

Education

High school diploma or GED

Tools

CRM systems

Case management systems

Healthcare platforms

Job description

MMC Group LP in Houston, Texas is seeking a Member Services Representative - Healthcare Support Specialist to join a fast-paced, on-site call center. The 3-month contract provides daytime, full-time hours with a pay rate of $19.69 per hour and potential extension based on performance.

The role handles inquiries related to healthcare benefits, eligibility, claims, and authorizations, ensuring accurate documentation and first-call resolution where possible.