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Member Experience Representative
Contract-to-Hire | Full-Time | 100% Onsite
Location: Northern Columbus Area, OH
Beacon Hill’s client is seeking service-driven professionals to join their team as Member Experience Representatives. This opportunity is perfect for individuals who enjoy helping others, resolving challenges, and delivering outstanding customer support in a healthcare-focused environment.
Position Summary
As a Member Experience Representative, you will be a trusted resource for individuals seeking assistance with healthcare coverage, claims, provider services, authorizations, and benefit-related questions. You will provide guidance, education, and support while helping members navigate complex situations and access the information they need to make confident healthcare decisions.
This role is ideal for compassionate professionals who thrive in a customer-focused setting, enjoy problem-solving, and are committed to creating positive experiences for every member interaction.
Schedule
After Training:
- Monday-Friday
- 10:00 AM – 7:00 PM EST
Training Period:
- 7 weeks of paid onsite training
- Monday-Friday
- 9:00 AM – 6:00 PM EST
Key Responsibilities
- Handle incoming and outgoing member communications related to healthcare benefits, eligibility, claims, provider networks, billing questions, and authorization requests.
- Explain healthcare plans, coverage details, and available services in a clear and easy-to-understand manner.
- Research member concerns, gather necessary information, and collaborate with providers, insurance partners, and internal teams to achieve resolutions.
- Assist members with understanding healthcare costs, coverage determinations, and benefit utilization.
- Support authorization and approval processes by providing updates and ensuring documentation requirements are met.
- Review and investigate claims inquiries while proactively following through on unresolved issues.
- Advocate for members by helping facilitate communication between healthcare providers and insurance organizations when challenges arise.
- Identify opportunities to improve the member journey through education, proactive outreach, and personalized assistance.
- Accurately document interactions and case activities while working across multiple software platforms.
- Provide professional and compassionate service during sensitive healthcare-related conversations.
Required Qualifications
- Strong customer service and communication skills.
- High School Diploma or GED required.
- Ability to demonstrate empathy and build rapport with customers.
- Effective problem-solving and critical-thinking abilities.
- Professional phone presence and excellent verbal communication skills.
- Reliable attendance and strong accountability.
- Proficiency with Microsoft Outlook, Word, Excel, PowerPoint, and Teams.
Beacon Hill offers eligible employees access to comprehensive benefits programs, including medical, dental, vision, and applicable federal and state leave benefits. Additional details regarding benefit offerings will be provided upon hire.
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