Role Description As a Member Services Representative, you will serve as the first point of contact for members seeking assistance with their health plan benefits, account status, and service-related inquiries. This is a high-impact, customer-facing role that requires empathy, attention to detail, and a commitment to delivering a high-quality member experience. Key Responsibilities: - Respond to inbound calls and digital inquiries from members regarding benefits, claims, payments, and services. - Resolve member concerns with professionalism and empathy, ensuring first-contact resolution whenever possible. - Document all interactions accurately in the system according to compliance and procedural standards. - Educate members on plan options and promote appropriate services when relevant. - Collaborate with internal departments and external partners (e.g., medical groups, facilities) to resolve complex issues. - Meet or exceed performance metrics including call handling time, resolution rate, and customer satisfaction. - Participate in ongoing training and coaching sessions to maintain up-to-date knowledge of products and procedures. Qualifications - 1-3 years of healthcare enrollment, pharmacy tech, healthcare call center dealing with insurances, or related experience. Requirements Technical & Functional: - Proficient with Windows-based systems (Outlook, Word, Excel, internet browsers). - Comfortable working across multiple systems simultaneously. - Strong problem-solving and critical-thinking skills. - Ability to work in a fast-paced, high-volume environment. Customer Service & Soft Skills: - Service-oriented mindset with a passion for helping others. - Patient, empathetic, and calm under pressure. - Positive, professional, and cooperative attitude. - Open to feedback and committed to continuous improvement. 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). Company Description TEKsystems is a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution, and operations unlocks business value through a range of solutions. - We are a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe, and Asia. - We partner with clients for our scale, full-stack capabilities, and speed. - We are strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. - We are building tomorrow by delivering business outcomes and making positive impacts in our global communities.

• Perform day-to-day activities required to process credit account balances • Serve as a member of a team responsible for reducing patient balance account receivable credits • Communicate with patients regarding overpayments • Document corrections on discrepancies and follow up activities performed • Track data on payment activity and findings for the Supervisor • Prepare refund checks and enter data into the appropriate system • Adhere to proactive cash posting practices

• Responding to telephone inquiries from providers & related entities regarding benefits, beneficiary eligibility, plan coverage and other related questions • Providing world-class customer service in a professional and timely manner for all inquiries regarding both the Martins Point USFHP and Generations Advantage programs • Answers verbal, written and electronic inquiries with complete and accurate information regarding Martin’s Point USFHP and Medicare program • Provides additional training when applicable to callers related to policies, procedures and existing self-service options • Responds to incoming inquiries and partners with provider on possible next steps and or resolution • Collaborates with PI Research team and / or other departments when needed to resolve Provider issues • Follows up in a timely manner with providers when first call resolution is not possible • Stays educated on existing and new information available through Provider Services internal resources • Documents all inquiries with accurate and detailed information, following all applicable workflows and as well as departmental and regulatory requirements • Uses soft skills to build trusting relationships in the context of mutual partnership creating a world class service experience for internal and external customers

• Manage client denials and concerns by conducting a comprehensive analytic review of clinical documentation • Deliver final determination based on trained skillsets and partnerships with clinical parties • Perform advanced administrative/operational/customer support responsibilities • Assist members by phone to further/support quality related goals • Investigate and resolve member and practitioner issues • Exercise discretion and judgment in prioritizing requests and interpreting procedures