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60 Emblemhealth Member Services Representative Jobs Hiring Near You

EmblemHealth

Customer Care Navigator

Manhattan, NY · On-site

$18.75 - $24.75/hr

Proactively research Emblem Health member issues utilizing multiple enterprise systems and data to ... customer service follow up. * Represent EmblemHealth to all visitors to the sites, including ...

EmblemHealth

Customer Care Navigator

Manhattan, NY · On-site

$18.75 - $24.75/hr

Proactively research Emblem Health member issues utilizing multiple enterprise systems and data to ... customer service follow up. * Represent EmblemHealth to all visitors to the sites, including ...

EmblemHealth

Customer Care Navigator

New York, NY

$18.50 - $24.50/hr

Proactively research Emblem Health member issues utilizing multiple enterprise systems and data to ... customer service follow up. * Represent EmblemHealth to all visitors to the sites, including ...

EmblemHealth

Customer Care Navigator

New York, NY · On-site

$56.16K - $99.36K/yr

Proactively research Emblem Health member issues utilizing multiple enterprise systems and data to ... customer service follow up. * Represent EmblemHealth to all visitors to the sites, including ...

EmblemHealth

Customer Care Navigator

New York, NY · On-site

$23 - $29.50/hr

Proactively research Emblem Health member issues utilizing multiple enterprise systems and data to ... service follow up. Represent EmblemHealth to all visitors to the sites, including internal and ...

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EmblemHealth Jobs Information

What are the key skills and qualifications needed to thrive as a Member Services Representative, and why are they important?

To thrive as a Member Services Representative, you need strong customer service skills, problem-solving abilities, and typically at least a high school diploma or equivalent. Familiarity with customer relationship management (CRM) software, basic office applications, and sometimes call center phone systems is often required. Outstanding communication, patience, and active listening are crucial soft skills for building positive member relationships. These skills ensure members receive timely, accurate assistance and foster long-term loyalty and satisfaction.

How does a Member Services Representative typically collaborate with other departments to resolve member issues?

Member Services Representatives often work closely with departments such as billing, technical support, and account management to address and resolve member concerns efficiently. When a member presents a complex issue, representatives coordinate with these teams to gather information, provide updates, and ensure a seamless resolution process. This cross-departmental collaboration not only helps in delivering excellent service but also provides opportunities to learn about different areas of the organization, which can be beneficial for career growth.

What does a Member Services Representative do?

A Member Services Representative is responsible for assisting customers or members with their inquiries, account management, and resolving issues related to products or services. They typically work in organizations such as credit unions, gyms, healthcare providers, or membership-based companies. Their main duties include answering questions, providing information, processing transactions, and ensuring a positive experience for members. Strong communication and problem-solving skills are essential for this role. They may also handle complaints, update member records, and promote additional services.

What is the difference between Member Services Representative vs Customer Service Representative?

AspectMember Services RepresentativeCustomer Service Representative
CredentialsHigh school diploma; some roles may require certifications in insurance or healthcareHigh school diploma; customer service training often preferred
Work EnvironmentHealthcare, insurance, or membership organizationsRetail, call centers, various industries
Employer & Industry UsageInsurance companies, healthcare providers, membership organizationsRetail stores, telecom, service providers
Common Search & ComparisonYesYes

Member Services Representatives primarily work in healthcare, insurance, or membership organizations, focusing on assisting members with their accounts, benefits, and inquiries. Customer Service Representatives work across various industries, handling general customer inquiries and support. While both roles require strong communication skills, Member Services Representatives often need specific industry knowledge related to healthcare or insurance. The roles overlap in customer interaction and problem-solving, but their industry focus and specific responsibilities differ.

What other companies are hiring for Member Services Representative jobs?
What are the most popular jobs at Emblemhealth?
What are the most popular categories at Emblemhealth?
Infographic showing various Member Services Representative job openings at Emblemhealth in the United States as of May 2026, with employment types broken down into 2% As Needed, and 98% Full Time. Highlights an 76% Physical, and 24% Remote job distribution.
Customer Care Navigator, Spanish Speaking - Brooklyn, NY

Customer Care Navigator, Spanish Speaking - Brooklyn, NY

EmblemHealth

New York, NY • On-site

$56.16K - $99.36K/yr

Full-time

Posted 13 days ago

Job description

Summary of Position
Work closely with onsite sales colleagues to identify customers in need of enrollment services and provide post sales customer service follow-up. Interact face-to-face with customers, assisting in providing complete resolution of customer concerns including claims, benefit and enrollment inquiries through health plan navigation, health and wellness coaching and community referrals. Proactively research Emblem Health member issues utilizing multiple enterprise systems and data to explain and resolve complicated customer service issues, close care gaps, helping complete HRAs, enabling higher retention of members within the neighboring community. Help conduct seminars and workshops on premises and will play an important role in class offerings for the department. Collaborate with enterprise team members on member retention efforts and special projects within the location including: Care Management and Quality to understand member needs in the community as they relate to gaps in care; and quality efforts to provide effective in person and outreach services within the community. Provide post sales customer service follow-up with Sales colleagues, both onsite and in the field within the region, to follow up on member customer service and care needs. Work with ACPNY teams, both co-located and within the region, to aid in care gap issues, especially as they relate to social needs and customer service follow up. Represent EmblemHealth to all visitors to the sites, including internal and external partners, groups and leaders. Maintain a primary Neighborhood Care location but also support multiple Neighborhood Care sites within a region.
Principal Accountabilities
  • Identify customer needs and help solve customer issues related to health plans, health and wellness and enrollment within regulatory guidelines; providing direct guidance or identifying other EmblemHealth (EH) and community resources to find customer solutions, conduct customer needs assessment, education on condition management. Understand and maintain excellent working knowledge of EmblemHealth products, services and technology platforms. Document interactions in support of quantitative metrics for the site and department.
  • Work with the manager to deliver and organize onsite health seminars and classes, including EH vendor-led classes.
  • Proactively communicate with customers, EmblemHealth departments and community partners the status of any outstanding issues until solved. Effectively describe final resolution to customer.
  • Work together with sales team to identify customers in need of enrollment services and post sales customer service follow-up. Proactively support operational aspects of other internal partners such as AdvantageCare Physicians, product, customer service and quality to help improve customer experience and operations.
  • Participate in weekly meetings with manager and team members across sites to discuss customer care issues, improvement opportunities, community offerings, and other site and company priorities.
  • Represent EmblemHealth at onsite interactions with community partners and leaders.

Qualifications
  • Bachelor's Degree
  • 3 - 5+ years of experience working with customers in customer service, medical or managed care environment (Required)
  • Experience in evidence-based health and lifestyle coaching techniques (Preferred)
  • Ability and willingness to attend appropriate training and certification classes (Required)
  • Additional experience/specialized training may be considered in lieu of educational requirements (Required)
  • Fluency in Spanish (verbal and written) (Required)
  • Experience communicating directly with customers, assessing needs, and connecting customers with resources (Required)
  • Knowledgeable on how to navigate all aspects of medical care and managed care system, and health and wellness (Required)
  • Ability to demonstrate excellent service knowledge and hospitality, and optimistic warmth and empathy for the customers' experience (Required)
  • Excellent communication skills (verbal, written, presentation, interpersonal) with all types/levels of audiences (Required)
  • Proficient with MS Office (Word, Excel, PowerPoint, Outlook, Teams, SharePoint, etc.) (Required)
  • Technologically savvy, with the ability to quickly learn and navigate different information technology systems (Required)
  • Flexibility to work in different Neighborhood Care sites when needed (Required)

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