Member Services Representative (Remote In Washington)
About The Position
The Member Services Representative plays a critical role in delivering exceptional customer service within a high-volume call center environment. This position is responsible for resolving inquiries and complaints from members, providers, and other stakeholders regarding health plan coverage, claims, referrals, eligibility, and service delivery issues. The ideal candidate will have prior experience in regulated industries such as healthcare or insurance and demonstrate strong communication and problem-solving skills in both remote and in-person settings.
Requirements
- High School Diploma or GED (must be verifiable).
- Minimum of 1 year experience in a high-volume call center.
- Prior remote work experience.
- Must pass Kaiser Permanente Call Center Assessments.
- Must complete the Interview Assessment.
- Must have a private/quiet workstation dedicated for shift hours
- Must be located near a Kaiser Permanente administrative hub (Renton or Spokane) or be willing to go onsite for IT/system support.
- Equipment must be picked up from one of the designated IT hubs.
Nice To Haves
- Experience in a healthcare or insurance call center environment.
- Familiarity with medical or health plan insurance member support.
- Experience working in regulated industries such as healthcare, insurance, banking, or credit.
Responsibilities
- Respond to member and provider inquiries via phone and email interactions with professionalism and accuracy.
- Resolve complaints related to health plan coverage, claims, referrals, eligibility, and service delivery issues.
- Provide clear and accurate information to members, prospective members, providers, agents, brokers, attorneys, and employer groups.
- Assist with appointment access, physician selection, fee quotes, and patient billing concerns.
- Document all interactions and resolutions in the appropriate systems to ensure compliance and continuity of care.
- Collaborate with internal departments to resolve complex issues and escalate when necessary.
- Maintain confidentiality and adhere to HIPAA and other regulatory requirements.
Benefits
- Medical, Dental & Vision
- 401(k)/Roth
- Basic/Supplemental Life & AD&D
- Short and long-term disability
- HSA & DCFSA
- Transportation benefits
- Employee Assistance Program
- Company Paid Time off or State Sick Leave
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
