Overview
We are seeking a candidate to join our team as a Customer Service Representative in Member Services. In this role, you will act as the primary point of contact for healthcare plan members, providing essential support regarding coverage, claims, and benefits. If you are an empathetic, dependable professional looking to grow your career within a top-tier healthcare system, we would love to connect with you!
Key Responsibilities
- Member & Provider Inquiries: Answer high-volume inbound calls regarding insurance benefits, coverage details, claims status, and billing statements.
- Issue Resolution: Handle member complaints and work diligently to resolve complex concerns with high empathy and emotional intelligence.
- System & Website Support: Guide members through website navigation, online account troubleshooting, and locating in-network healthcare providers.
- Billing & Financial Support: Respond to inquiries concerning premium amounts, remittance, provider assistance units, and Medicare units.
- Multitasking: Navigate multiple internal computer systems and software tools simultaneously while assisting callers on live lines.
Work Environment & Schedule
- Work Modality: 100% Remote. Candidates must be local to either Spokane, WA, or Renton, WA, for initial equipment pickup and in the event of tech/outage support.
- Class Start Date: September 14, 2026.
- Training Phase: 8:30 AM - 5:00 PM PST (Monday through Friday) for the first 3 weeks. Attendance is mandatory for all training sessions.
- Nesting Phase: 8:30 AM - 5:00 PM PST for 2 to 3 weeks following classroom training, working directly with hands-on mentors.
- Regular Schedule: After training and nesting, assigned shifts will fall within the operating window of 7:00 AM - 5:00 PM PST (8-hour daily shifts, 40 hours per week).
Requirements & Qualifications
Required:
- Experience: Minimum of 1 year of high-volume call center experience.
- Education: High School Diploma or GED (verification required).
- Technical Setup: Dedicated, quiet, and private home workspace with high-speed internet.
- Skills: Strong customer service background, computer proficiency, active listening, and the ability to handle upset callers with patience and professionalism.
Preferred:
- Background or prior experience working in the healthcare/health insurance industry.
Background & Compliance
- Full employment history and education verification are required.
- Pre-employment background check (including Washington criminal search).
- Drug screen required (note: drug panel tests for marijuana).
* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
* As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients