Member Service Specialist

Relation Insurance•Tulsa, OK

4d•Onsite

About The Position

The Member Service Specialist serves as a primary point of contact for members and providers while also providing essential back end and administrative support to ensure timely and accurate resolution of inquiries. The individual in this role is responsible for answering inbound calls, managing shared inboxes, completing follow-up work, conducting research, and performing outbound communications. The Member Service Specialist collaborates closely with internal teams to achieve first call resolution whenever possible and ensures seamless handling of ongoing or complex requests.

Requirements

High school diploma or equivalent required.
Previous customer service experience, preferably in a call center, healthcare, insurance, or administrative support environment.
Strong verbal and written communication skills.
Ability to multitask, prioritize, and meet response-time expectations in a fast-paced setting.
High attention to detail and documentation accuracy.
Professional demeanor with strong interpersonal, collaboration, and time management skills.
Basic computer proficiency and ability to learn new systems.

Nice To Haves

Experience in member services, healthcare, or insurance operations preferred.
Familiarity with shared inboxes, ticketing systems, call tracking, or CRM/case management systems preferred.
Experience documenting work in CRM or case management platforms preferred.
Prior experience working in a team-based support environment preferred.

Responsibilities

Answers inbound calls promptly and professionally.
Strives to achieve first call resolution whenever possible.
Provides accurate information regarding benefits, services, and requests.
Accurately documents all calls, actions, and resolutions in call tracking and case management systems.
Manages and responds to inquiries in shared and assigned inboxes promptly, professionally, and with empathy.
Completes follow-up work and administrative tasks to support member and provider requests.
Conducts research and performs outbound communications to resolve inquiries.
Assigns appropriate call statuses (e.g., First Call Resolution or Open).
Takes ownership of assigned and claimed tasks to ensure timely completion.
Communicates follow-up needs clearly and collaborates across teams as required.
Provides phone coverage during periods of high call volume or operational need.
Identifies and communicates trends, recurring issues, and process improvement opportunities to leadership.
Fully adopts innovative technology, including proprietary AI solutions, into the service process to deliver a best-in-class client service experience.
Performs other projects, duties, and tasks, as assigned.