Call Center Representative (Member Services) - USFHP

Providence • Renton, WA

11d

About The Position

Be the voice our heroes trust when they need help. At PacMed’s US Family Health Plan (USFHP), every interaction matters. As a Member Services Representative, you will serve as a trusted resource for uniformed service members, retirees, and their families, helping them understand their benefits, navigate the healthcare system, and resolve concerns with professionalism, empathy, and accuracy. In this frontline role, you will assist members and providers with questions about benefits, eligibility, referrals, claims, billing, appointment access, and coverage options. Using an automated call distribution (ACD) system, you will manage a high volume of inbound inquiries while delivering timely, accurate service through phone, written, and electronic communication channels. You will also process correspondence, respond to written inquiries, and document interactions to ensure effective tracking and follow-up. Success in this position requires strong customer service skills, critical thinking, and the ability to prioritize tasks while working independently. You will guide members through complaint, grievance, and appeals processes, help new enrollees understand their coverage, and collaborate with providers, clinics, and internal teams to support positive outcomes. Strong communication skills, attention to detail, and a calm, solution-focused approach are essential. Experience with health insurance, managed care, medical terminology, or TRICARE benefits is helpful, but equally important is a commitment to delivering exceptional service with compassion and respect.

Requirements

• 2 years of experience in healthcare field customer service position.

Nice To Haves

• Post secondary education.
• 2 years of experience in healthcare field customer service position in an HMO setting.
• Call Center Experience
• Experience with health insurance, managed care, medical terminology, or TRICARE benefits.

Responsibilities

• Assist members and providers with questions about benefits, eligibility, referrals, claims, billing, appointment access, and coverage options.
• Manage a high volume of inbound inquiries using an automated call distribution (ACD) system.
• Deliver timely, accurate service through phone, written, and electronic communication channels.
• Process correspondence and respond to written inquiries.
• Document interactions to ensure effective tracking and follow-up.
• Guide members through complaint, grievance, and appeals processes.
• Help new enrollees understand their coverage.
• Collaborate with providers, clinics, and internal teams to support positive outcomes.

Benefits

• Best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree