What are the responsibilities and job description for the Member Services Specialist position at ADN Group?
Job Title: Member Services Specialist - Onsite
Location: Irving, TX, United States
Work Type: Onsite
Work Hours: Monday to Friday, 9:00 AM - 5:00 PM (CST)
Duration: Approximately 3 months (98 days)
Hourly Rate: $18.13/hr
Reward Amount: $2.33/hr
Job Summary:
The Member Services Specialist serves as a frontline ambassador for the health plan, providing high-quality, resolution-focused support to members, providers, and brokers. This role is responsible for managing both telephonic and in-person interactions, assisting customers with healthcare and insurance-related inquiries, and ensuring accurate documentation of all interactions. Specialists develop proficiency in core internal systems, eligibility verification, claims review, and member account management.
Key Responsibilities:
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Facilitate member and provider understanding of plan coverage and benefits by researching inquiries thoroughly and professionally.
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Handle incoming and outgoing calls, written correspondence, and in-person member requests.
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Document all customer interactions accurately in the system to maintain a clear audit trail.
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Assist in training and retraining new and current employees as needed.
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Triage requests to appropriate departments such as Utilization Management or Provider Relations.
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Support first-call resolution for members, providing guidance on portal navigation, claims, and account management.
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Maintain a strong understanding of multiple lines of business and benefit structures.
Requirements:
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High School Diploma or equivalent required.
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Minimum of 2 years of customer service experience in healthcare, insurance, or call center environment.
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Excellent communication and interpersonal skills.
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Proficiency with Microsoft Word, Excel, and other relevant MIS systems.
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Ability to document interactions accurately and clearly.
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Strong problem-solving skills and attention to detail.
Skills:
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Healthcare knowledge
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Insurance knowledge
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Member services support
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Claims handling
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Customer service excellence
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Data entry and documentation
Salary : $2 - $18