Member Services Representative
Job Description: Member Services Representative
*Location:* Akron/Canton Area, Ohio
*Department:* Member Services – General
*Contract Duration:* November 16, 2026 – December 31, 2026
*Work Schedule:* Monday–Friday, 8:00 AM – 5:00 PM
*Position Type:* Seasonal, Long-Term Assignment
*Open Positions:* 6
*Experience Required:* More than 2 years
Position Overview:
We are seeking experienced and customer-focused *Member Services Representatives* to provide personalized assistance to health plan members. The ideal candidates will have a strong background in customer service, call-center operations, or administrative support, with experience in Medicare and/or health insurance strongly preferred.
This role involves responding to member inquiries, resolving concerns, explaining benefits and eligibility, documenting interactions, and coordinating with internal departments to ensure timely and accurate service.
*Important Location Requirement:* Candidates must reside within the Akron/Canton, Ohio area to be considered.
Key Responsibilities:
- Provide personalized customer service to members via telephone, electronic communication, and in-person interactions as required.
- Respond to inquiries regarding enrollment, benefits, eligibility, billing, claims, and authorizations.
- Investigate member concerns and complaints, identify appropriate solutions, and coordinate with relevant departments for resolution.
- Accurately document all member interactions, inquiries, and complaints in the designated tracking systems.
- Meet established departmental productivity, service quality, and communication standards.
- Explain health insurance policies, procedures, and benefits clearly and professionally.
- Demonstrate empathy, patience, and a customer-first approach while handling sensitive or complex inquiries.
- Utilize computer systems and internal applications, including Amisys and Macess, as applicable.
- Exercise sound judgment and problem-solving skills when interpreting procedures and addressing member concerns.
- Maintain confidentiality of protected health information and other sensitive business information.
- Comply with applicable regulatory requirements, organizational policies, and departmental procedures.
- Manage time effectively and adapt to changing priorities in a fast-paced call-center environment.
Required Qualifications:
- High school diploma or GED required; college experience preferred.
- More than *2 years of experience in customer service, call-center operations, administrative support, or similar responsibilities*.
- Strong verbal and written communication skills.
- Proficiency with Windows-based computer systems and standard office applications.
- Good keyboarding, documentation, and multitasking skills.
- Ability to operate computer systems, telephone equipment, headsets, and other standard office tools.
- Excellent customer service, active listening, conflict resolution, and problem-solving abilities.
- Professional telephone etiquette and the ability to communicate with empathy, confidence, and courtesy.
- Ability to learn health insurance policies, procedures, and applicable regulations.
- Strong organizational skills and the ability to meet productivity and quality targets.
- Ability to maintain confidentiality and handle sensitive member information appropriately.
Preferred Qualifications:
- Previous experience in *Medicare and/or health insurance is strongly preferred*.
- Experience handling member benefits, enrollment, claims, billing, eligibility, or authorization inquiries.
- Familiarity with health insurance customer service systems, particularly Amisys and Macess.
- Previous experience in a high-volume call-center environment.
Work Location and Training Requirements
- Candidates *must live within the Akron/Canton, Ohio area*.
- Initial orientation and training will be conducted *in person for approximately four weeks*.
- Employees may be required to report to the office periodically throughout the contract.
- Candidates must be comfortable working in an office-based training environment and a potentially remote work environment thereafter, subject to business requirements.
- Flexibility to adjust work arrangements or hours to meet operational needs is required.
Physical Requirements:
- Ability to sit for prolonged periods.
- Ability to bend, stoop, and stretch as needed.
- Ability to lift up to 20 pounds.
- Manual dexterity to operate computers, phones, and standard office equipment.
Onboarding Requirements
Selected candidates must complete the required onboarding and compliance process, including:
- Updated resume and professional references.
- Government-issued driver's license or state identification.
- Education verification.
- Background checks and applicable exclusion-list screenings.
- Drug screening.
- Required health documentation, including influenza vaccination documentation and annual TB questionnaire.
Important Submission Guidelines
- *Local candidates only:* Applicants must reside within the Akron/Canton area.
- *Experience:* More than 2 years of relevant experience is required.
- *Healthcare background:* Medicare and/or health insurance experience is strongly preferred.
- *Previous submissions:* Do not submit candidates who have already been submitted and rejected for previous orders.
- *Availability:* Candidates should be available to begin on November 16, 2026, subject to onboarding requirements.
How to Apply:
Interested candidates should submit an updated resume highlighting relevant customer service, call-center, administrative support, and health insurance experience.
Candidates with strong communication skills, a customer-focused attitude, and experience supporting health plan members are encouraged to apply.
Pay: $19.00 - $20.00 per hour
Expected hours: 40.0 per week
Work Location: In person