Remote Member Services Specialist — Rx & Claims

Southern Scripts; Oregon; Hybrid; USD 22,000 - 33,000; Part time

Job summary

Southern Scripts is seeking a dedicated Member Services Agent to work remotely in the United States. You will assist customers with Rx claims information, maintain accurate records, and follow up on inquiries while protecting PHI under HIPAA.

Responsibilities include resolving issues, coordinating with internal teams, and delivering high-quality service over phone, email, or chat. A high school diploma and prior customer service experience are required, with strong computer skills and

Qualifications

• High school diploma or equivalent.
• Customer service experience required.
• Basic computer experience.

Responsibilities

• Provide information about Rx claims processing by phone.
• Keep detailed records of customer interactions and transactions.
• Follow up to resolve customer issues and notify relevant departments.
• Ensure HIPAA compliance and protect PHI.
• Refer unresolved grievances for investigation.
• Review Rx insurance policy terms for claim coverage.
• Respond to inquiries and inform customers of investigation results or adjustments.
• Resolve service or billing complaints.
• Assess information to determine validity of complaints.

Skills

Computers proficiency

Communication

Information gathering

External communication

Processing information

Conflict resolution

Knowledge updating

Organization & planning

Administrative tasks

Decision making

Customer focus

Problem solving

Time management

Communication proficiency

Teamwork

Technical capacity

Multitasking

Education

High School or equivalent

Job description

Southern Scripts is seeking a dedicated Member Services Agent to work remotely in the United States. You will assist customers with Rx claims information, maintain accurate records, and follow up on inquiries while protecting PHI under HIPAA.

Responsibilities include resolving issues, coordinating with internal teams, and delivering high-quality service over phone, email, or chat. A high school diploma and prior customer service experience are required, with strong computer skills and