Member Services Specialist
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Job Location:
Irving, TX - USA
Monthly Salary:
Not Disclosed
Posted on:
3 hours ago
Vacancies:
1 Vacancy
Job Summary
Member Services Specialist - ONSITE Submit with HS Diploma Irving Corporate Health Plan Administration Office 5101 OConnor Blvd Irving TX 75039
Monday-Friday 8 hours
Summary: The Member Services Specialist serves as a frontline ambassador for the health plan delivering high-quality resolution-focused support to members providers and brokers across multiple lines of business.
As the initial point of contact this role extends beyond basic call handling-Specialists are trained to navigate the foundational pillars of our healthcare offerings including the Health Exchange US Family Health Plan and NCHD with a strong emphasis on first-call resolution.
Specialists develop working knowledge of benefit structures assist callers with portal navigation and access and begin interpreting claims activity to support both member and provider inquiries.
This position blends customer service excellence with technical skill-building offering exposure to internal systems regulatory protocols and cross-functional workflows.
Specialists are expected to gain proficiency in core platforms used for eligibility verification claims review and member account management (e.g. HSP HPS HealthTrio).
All interactions must be documented with a clear and concise recap of the calls purpose following prescribed workflows and audit-ready standards.
This role provides a structured pathway for advancement with progressive training in claims interpretation premium payment processing and multi-line service delivery laying the foundation for future specialization and leadership opportunities.
Responsibilities: Meets expectations of the applicable One Competencies: Leader of Self Leader of Others or Leader of Leaders. Begin mastery of four core systems (e.g. HSP HPS HealthTrio and Zelis) to independently resolve inquiries and complete calls with accu
