Provider Service Representative

HW Staffing Solutions; Portland (ME); On-site; USD 36,000 - 48,000; Full time

Job summary

HW Staffing Solutions in Portland, ME is seeking a Member Services Representative I to support health plan members by answering questions, resolving issues, and providing accurate information on benefits, claims, eligibility, and coverage. The role involves handling member inquiries by phone and written communication, researching issues, and documenting interactions.

You will navigate multiple systems and collaborate with internal teams to ensure compliant, high-quality service.

Qualifications

• High School Diploma or equivalent required.
• 2+ years of customer service experience.
• Strong communication, problem-solving, and computer skills.

Responsibilities

• Assist members via phone and written communication.
• Research and resolve inquiries while maintaining accurate documentation.
• Navigate multiple systems to provide timely and accurate support.
• Collaborate with internal teams to address member needs.
• Deliver outstanding customer service while meeting compliance standards.

Skills

Customer service

Communication

Problem-solving

Computer skills

Education

High School Diploma or equivalent

Job description

We are seeking a Member Services Representative I to provide exceptional support to health plan members by answering questions, resolving issues, and providing accurate information regarding benefits, claims, eligibility, and coverage.

Responsibilities

• Assist members via phone and written communication.
• Research and resolve inquiries while maintaining accurate documentation.
• Navigate multiple systems to provide timely and accurate support.
• Collaborate with internal teams to address member needs.
• Deliver outstanding customer service while meeting compliance standards.

Qualifications

• High School Diploma or equivalent required.
• 2+ years of customer service experience.
• Strong communication, problem-solving, and computer skills.

Preferred Experience

• Medical billing
• Healthcare or health insurance
• Medical office, claims, or provider services
• Benefits and eligibility verification
• Healthcare terminology
• Working with healthcare providers or medical offices