Healthcare Member Service Representative

TEKsystems

5d•Onsite

About The Position

We are seeking a Member Services Representative to support members and health plans with inbound calls related to eligibility, authorizations, referrals, and general service needs. This role is ideal for individuals who thrive in a Fast‑Paced Healthcare Call Center Environment, enjoy helping others, and maintain professionalism under pressure.

Requirements

Customer Service
Call Center or Phone Support Experience
Data Entry
Medical Terminology
Healthcare Industry Experience
Eligibility & HMO Insurance Knowledge
A strong customer‑first mindset
Ability to remain calm and empathetic in high‑volume situations
Excellent communication skills
Reliable, organized, and detail‑oriented work habits
Interest in growth within the healthcare support field

Nice To Haves

Healthcare call center experience
Medical office support experience
Customer support or help desk experience
Strong attention to detail
Bilingual (preferred)

Responsibilities

Manage High‑Volume Inbound Calls from members and health plans
Maintain productivity standards of 45–50+ Calls Per Day with accurate documentation
Identify caller needs and determine appropriate resolution or escalation
Utilize standardized workflows to assist with: Eligibility inquiries, Referral status and designated referrals, Provider availability, General service issues
Process demographic updates and maintain accurate member records
Maintain Strict HIPAA Compliance and confidentiality
Perform administrative duties including Faxing, Scanning, And Filing
Provide Professional, Polished Verbal And Written Communication
Demonstrate Empathy, Patience, And Sound Judgment With Each Interaction