Member Services Support Specialist

Imagine360•,

7d•Remote

About The Position

Imagine360 is seeking a Member Services Support Specialist (MSSS) to provide specialized support and education to members of terminated accounts. The role guides members through the run-out balance-bill defense process, working closely with the legal team and external stakeholders to resolve issues promptly and support a positive member experience. The position manages an assigned member caseload using a proactive advocacy model, with a specialized focus on balance billing for members and employees of terminated clients. It coordinates communication and issue resolution among members, clients, medical providers, and internal and external legal representatives; analyzes billing activity and financial impacts to recommend balance-bill settlements; and tracks inquiries, resolutions, documentation, and follow-up. The role also collaborates with internal stakeholders on service issues and process or system improvements, while applying knowledge of HIPAA regulations. This position is 100% remote.

Requirements

High school diploma or GED.
Some college.
At least 1 year of related member support experience.
Proficiency in Microsoft Outlook, Microsoft Word, Excel, and internet navigation.
Excellent written and verbal communication skills.
Advanced problem-resolution skills.
Ability to make independent decisions and apply critical thinking.

Nice To Haves

Experience in billing, insurance, healthcare, or legal environments.

Responsibilities

Manage an assigned member caseload through proactive advocacy, focusing on member experience and engagement.
Provide specialized support to members and employees of terminated clients regarding run-out balance billing.
Use independent critical thinking and judgment to help members with balance-bill issues and inquiries.
Coordinate elevated internal and external member issue resolution with urgency; act as the point person for inquiries, issues, and concerns, and ensure timely resolution and remediation.
Facilitate and coordinate communication with members, clients, medical providers, and in-house and external legal representatives.
Analyze billing activity and related financial impacts to make strategic balance-bill settlement recommendations.
Establish rapport with members and internal counterparts.
Track the status and resolution of member inquiries and issues.
Maintain accurate, complete documentation and follow-up diaries throughout the process.
Collaborate with internal stakeholders to address service issues and identify process or systemic enhancement opportunities.
Apply strong knowledge of HIPAA regulations.

Benefits

Multiple health plan options.
Company-paid employee premiums for disability and life insurance.
Parental leave policy.
20 days of PTO to start.
10 paid holidays.
Tuition reimbursement.
401(k) company contribution.
Company-paid short- and long-term disability and life insurance.
Professional development initiatives and continuous learning opportunities.
Opportunities to participate in and support diversity and inclusion initiatives.