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TEKsystems

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia.

Member Experience Representative

Location

United States

Posted

6 days ago

Salary

$18 / hour

Seniority

Mid Level

No structured requirement data.

Job Description

Member Experience Representative

TEKsystems

Role Description We are seeking customer-focused professionals to join our team as a Member Experience Representative. In this role, you will serve as the primary point of contact for members, providers, customers, and brokers, assisting with questions related to health insurance coverage, claims, benefits, billing, and authorizations. This is an excellent opportunity for individuals with healthcare customer service, insurance, or call center experience who enjoy helping others and solving problems in a fast-paced environment. - Answer incoming calls and emails from members, providers, customers, and brokers. - Assist with questions regarding: - Health insurance coverage - Claims status - Benefit interpretation - Billing inquiries - Prior authorizations - Investigate and resolve member concerns while striving for first-call resolution. - Clearly explain healthcare and insurance information in an easy-to-understand manner. - Document all interactions accurately within company systems. - Research member issues and collaborate with internal departments to resolve concerns. - Escalate complex issues when appropriate. - Maintain confidentiality and protect sensitive member health information. - Meet quality, service, and productivity metrics. Qualifications - Minimum of 2 years of healthcare customer service or call center experience. - Experience working with: - Commercial insurance - Insurance verification - Explanation of Benefits (EOBs) - Prior authorizations - Strong customer service and problem-solving skills. - Excellent verbal and written communication abilities. - Ability to navigate multiple computer systems simultaneously. - Intermediate Microsoft Office skills, including Outlook, Word, and Excel. - Ability to work independently in a remote environment. Requirements - Medicare experience (preferred). - Health plan or health insurance experience (preferred). - Previous call center experience (preferred). - Knowledge of insurance concepts and terminology (preferred). Benefits - Medical, dental & vision. - Critical Illness, Accident, and Hospital. - 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available. - Life Insurance (Voluntary Life & AD&D for the employee and dependents). - Short and long-term disability. - Health Spending Account (HSA). - Transportation benefits. - Employee Assistance Program. - Time Off/Leave (PTO, Vacation or Sick Leave). Training & Schedule - Training: First 6-8 weeks, Monday-Friday, 8:00 AM - 4:30 PM CST. - After Training: Monday-Friday, 8:00 AM - 4:30 PM CST or 8:30 AM - 5:00 PM CST. Job Type & Location This is a Contract to Hire position based out of Menasha, WI. The pay range for this position is $18.25 - $18.25/hr. Application Deadline This position is anticipated to close on Jul 15, 2026.

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