Member Services Specialist

SGS_JOB_3139

Admin/Clerical
 Texas
Customer Service
member service
insurance
claims
healthcare

Contract - 3 months + (Possibilities of Contract Extension)

Location : Irving, TX 75039 The Member Services Specialist will play a crucial role in ensuring our members' highest level of customer satisfaction. The Specialist will be responsible for providing exceptional customer service and resolving inquiries, concerns, and complaints professionally and on time. The primary focus will be on assisting members with their healthcare-related needs, including but not limited to insurance inquiries, benefit explanations, and general account information. Within the Member Services Specialist team, this entry role provides an opportunity for growth and development within our organization

Job Responsibilities:

  • Meets expectations of the applicable Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Respond to inbound calls, emails, and member chat messages regarding healthcare-related questions and concerns.
  • Adhere to established service level agreements (SLAs) and quality standards to consistently deliver excellent customer service about insurance benefits, claims, coverage, and other related inquiries. Assist members in navigating the healthcare system and understanding their rights and responsibilities.
  • Investigate and resolve member complaints, issues, and escalations promptly and satisfactorily. Document all customer interactions and issue resolutions accurately and comprehensively in the CRM system.
  • Collaborate with internal departments to facilitate issue resolution and ensure a seamless customer experience.
  • Explain insurance plans, policies, and procedures to members, ensuring they understand their benefits and coverage clearly.
  • Provide guidance on accessing healthcare services, locating in-network providers, and understanding pre-authorization requirements.
  • Continuously enhance product knowledge and stay updated on industry trends and changes.
  • Identify process improvement opportunities and provide recommendations to enhance the overall member experience.
  • Proactively contribute to the development and implementation of customer service best practices.
  • Collaborate with team members and management to improve operational efficiency and streamline workflows and customer satisfaction.
  • Support USFHP, HIX, and NCHD LOB as needed. Participate in training sessions and professional development activities to enhance knowledge and skills.

Skills:

  • Customer Service,
  • Member service
  • Insurance
  • Claims

Education/Experience:

  • A High School diploma or equivalent is required. 0 -2 years of customer service experience is preferred. Work Type: Full Time

Related Jobs

Mailroom specialist

Admin/Clerical
 Georgia
07 Months

Location : Atlanta GA USA 30339. A Mailroom specialist will be responsible for opening, prepping, and scanning incoming mail, including electronic mail, as well as processing outbound mail using postal equipment such as inserters, postage meters, and computers. Duties may also include handling outgoing overnight packages and assisting with other mail-related tasks as assigned. This role requires strong organizational skills, basic computer knowledge, flexibility to handle various assignments, and the ability to lift up to 50 pounds. Prior mailroom or shipping experience is preferred but not required.

Mailroom Operations / Detail-Oriented / Organizational Skills / Computer Proficiency

Patient Registration Rep

Admin/Clerical
 Michigan
6 months

Location (mandatory): Grand Blanc, MI 48439 Looking for candidate that has experience with using medical terminology

medical terminology
patient registration
hospital experience

R&D Project Coordinator

Admin/Clerical
 Arizona
12 Months (Contract,

Location (mandatory): Tucson, AZ 85755 The System Support Specialist is responsible for ensuring the maximum availability and performance of advanced production, manufacturing, and automation equipment. This hands-on role involves comprehensive installation, maintenance, and troubleshooting of mechanical, electrical, and control systems. You will work independently under limited supervision to perform complex breakdown analysis, preventative maintenance (PM), equipment upgrades, machinist and technical skills in a fast-paced industrial environment. You will be based at our LaGrange, Georgia print plant and will report to the Associate Director, Production. Shift: *Candidates must be able and willing to work Sunday-Thursday or Monday-Friday (site is closed on Saturdays) on both the mid and night shifts: -Mid Shift: 10AM-6PM (work 7 hours, 1 hour unpaid lunch) -Night Shift: 1PM-9PM (work 7 hours, 1 hour unpaid lunch) ***Candidates must work holidays

EDMS
Electronic Document Management System
planning
scheduling
tracking

Operations Clerk III

Admin/Clerical
 Texas
6 months

Location (mandatory): Houston, TX 77032 The Operations Support Associate will be responsible for completing standard and non-routine business processes to support sales and branch operations ensuring that customer contracts, billing, invoicing, and issues of any administrative nature are resolved in a timely fashion. This role can support various and multiple business units and is critical to ensure proper documentation, payment, and resolution of customer issues.

customer contracts
billing
invoicing
ERP systems
SAP
documentation
payment
and resolution of customer issues

Customer Service Representative III

Admin/Clerical
Ontario
6 months

Location : Toronto, ON M9W 6K9 (Canada) The Customer Support Specialist is responsible for managing customer orders, resolving billing issues, and providing pre- and post-sales support. This includes processing product and service orders, preparing quotes, maintaining accurate customer records, coordinating with internal departments on shipping and product availability, and ensuring efficient order fulfillment. The role also involves handling customer billing disputes, negotiating settlements, and ensuring customer satisfaction through timely resolution.

CRM
ERP
and quoting tools
Processing product and service orders
Preparing quotes and maintaining accurate customer records
Coordinating with internal departments on shipping and product availability
and Ensuring efficient order fulfillment

Mailroom Clerk

Admin/Clerical
 Maryland
12 Months (possible extension)

Small Description: This is a part-time, one-Friday-per-month Magazine Inserter role at the White Oak/Silver Spring, MD location. The position requires a self-motivated, organized individual who can work independently, stand for the full shift, and lift 10–15 pounds.

Physical Stamila
Mobility
Lifting
Mail
Basic computer skill

HR Analyst III

Admin/Clerical
 Texas
06 Months + (Possibilities of Contract Extension)

Location : Houston TX USA 77047 The Investigator, Employee Relations plays a critical role in cultivating a fair, inclusive, and high-trust workplace. You’ll handle sensitive employee matters with care, consistency, and integrity—conducting impartial, thorough investigations and partnering across teams to promote accountability and belonging.

Investigation
Employment Law
HR Practices
Compliance
Word
Excel
PowerPoint

Customer Service Representative I

Admin/Clerical
 New Jersey
19.00
03 months

Location (mandatory): Edison NJ Provides support to customers and the sales team by performing the following duties.

Customer service
EDI
order entry

Quality Assurance Inspector – I

Admin/Clerical
 Massachusetts
12 Months +

Location (mandatory): 1100 N. Arlington Heights Rd, Suite 400, MA 01810 The main function of a Quality Assurance Inspector is to ensure that products, materials, and processes meet established quality standards and regulatory requirements. A typical Quality Assurance Inspector performs batch record reviews, and collaborates with production teams to maintain consistent product quality.

Quality assurance
attention to detail
analytical thinking
regulatory compliance
documentation
batch record review
quality management systems
logo

At SGS Consulting, we go beyond resume-job matches, creating meaningful connections and pathways for individuals to thrive in defining careers.


2025. All right reserved.
logologologologo