Member Services Representative

Job Title : Member Services Representative (Healthcare)

Location : Temple, TX 76502

Duration : 3 Months – Temp to Perm

Education : HS Diploma / GED

Shift Details : 7 : 00 AM – 7 : 00 PM

Specific Skills :

• Communicate health plan policies, procedures, and services to members
• Answer inbound calls while meeting call handling and quality metrics
• 80% of calls answered within 30 seconds
• Call abandonment rate under 5%
• Average hold time not to exceed 2 minutes
• Serve as the first point of contact for benefits, premiums, and basic enrollment inquiries
• Verify and update member demographic information in plan systems
• Resolve member concerns efficiently and prevent escalation
• Access appropriate resources to provide accurate benefit information
• Accurately document all member interactions according to department standards

General Description :

The Member Customer Advocate serves as the primary point of contact for health plan members. Under general supervision, this role provides accurate information regarding benefits, policies, payments, and enrollment while delivering excellent customer service and first-call resolution in a fast-paced, call-center environment.