Remote Health Benefits Specialist

Apex Systems; Akron (OH); Hybride; USD 22 000 - 23 000; Plein temps

Avantages offerts par ce poste

Medical, dental, vision insurance

401K with company match

Health Savings Account (HSA)

Employee Assistance Program (EAP)

Certification discounts

Résumé du poste

Apex Systems, LLC is seeking a Member Services Representative II for a primarily remote role in the United States. You will assist members with health insurance benefits, eligibility, enrollment, and claims inquiries, delivering accurate information and excellent service.

The role requires strong communication, empathy, and problem-solving skills, with experience in healthcare or insurance operations and adherence to HIPAA and privacy standards.

Qualifications

• High School Diploma or GED required; Associate degree preferred.
• Minimum of 2 years in customer service, member services, call center, healthcare administration, or insurance operations.
• Experience supporting Medicare members or health insurance plans preferred.

Responsabilités

• Serve as the primary contact for members via phone, email, and other channels.
• Assist with questions related to health insurance benefits, eligibility, enrollment, claims processing, billing inquiries, authorizations, and coverage concerns.
• Document all interactions in internal tracking systems with accuracy.
• Escalate complex issues and coordinate resolution with internal teams.
• Collaborate with Enrollment, Claims, Billing, Care Management, and Provider Relations to resolve concerns.

Connaissances

Customer service

Communication

Empathy

Attention to detail

Problem solving

CRM software

Case management

VPN & remote tools

Formation

High school diploma or GED

Associate degree (preferred)

Outils

Microsoft Windows

CRM platforms

Case management systems

Healthcare administration software

Description du poste

Apex Systems, LLC is seeking a Member Services Representative II for a primarily remote role in the United States. You will assist members with health insurance benefits, eligibility, enrollment, and claims inquiries, delivering accurate information and excellent service.

The role requires strong communication, empathy, and problem-solving skills, with experience in healthcare or insurance operations and adherence to HIPAA and privacy standards.