Patient Service Representative

About the Role

We’re looking for a compassionate and detail-oriented Member Services Representative to join our team. In this role, you’ll be the first point of contact for our health plan members—helping them navigate their benefits, resolve issues, and feel supported throughout their healthcare journey.

Key Responsibilities

• Respond to member inquiries via phone, email, and chat regarding benefits, eligibility, claims, and referrals.
• Conduct welcome calls and assist members with account setup and portal navigation.
• Explain plan coverage, policies, and wellness program requirements.
• Document all interactions accurately and maintain compliance with HIPAA and internal privacy standards.
• Collaborate with internal departments to resolve member concerns and ensure timely follow-up.

Additional Skills & Qualifications

• High School Diploma REQUIRED

o Experience in a healthcare call center environment

o Need at least 1 year of call center

o High volume inbound calls 60-80 calls

o Be able to multitask

o Understanding HIPPA compliance, Medicare

o Multi-line phone experience

• Excellent soft skills, research, and investigative work

Experience Level

Entry Level

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