Member Service Representative

Member Services Representative (Remote - WA Local)
Locations: Remote (Must reside local to Renton, WA or Spokane, WA for equipment pickup/logistics)
Training: 3 Weeks (8:30 AM - 5:00 PM, M-F)
Post-Training Shift: Assigned 8-hour shift within the window of 8:00 AM - 8:00 PM, Sunday through Saturday.

Overview of the Role:
As a Member Services Representative, you are the face of our organization. You will handle a high volume of inbound calls, acting as a subject matter expert on insurance benefits, billing, and provider networks. We are looking for empathetic "problem-solvers" who can navigate complex healthcare systems while providing a world-class member experience.

Key Responsibilities:
Member Advocacy: Address inquiries regarding insurance coverage, benefits, and detailed billing statements.

Provider Navigation: Assist members in locating in-network healthcare providers and facilities.

Financial Guidance: Explain premium amounts, remittances, and navigate specialized units like Medicare and Provider Assistance.

Technical Support: Help members troubleshoot website navigation and portal login issues.

Resolution Management: De-escalate and resolve member complaints with empathy and professional judgment.

Required Qualifications:
Experience: Minimum 1 year of professional Call Center experience.

Education: High School Diploma or equivalent.

Tech Savvy: Ability to multitask across multiple software systems simultaneously while maintaining a conversation.

Reliability: A quiet, dedicated, and distraction-free home workspace.

Local Residency: Must live within commuting distance of our Renton or Spokane administration sites to pick up company-provided equipment.

Preferred Skills:
Previous experience in Healthcare or Insurance.

Knowledge of Medicare guidelines and billing terminology.

Training & Onboarding (The First 6 Weeks):
Classroom Phase (Weeks 1-3): Intensive virtual classroom training. Attendance is mandatory; no time off can be granted during this period.

Nesting Phase (Weeks 4-6): Transition to live calls with 1-on-1 mentor support and daily performance debriefs.

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.