Member & Provider Care Specialist

• About Our Client: The organization operates in the health insurance industry, focusing on delivering insurance services through a full stack technology platform. Founded in 2012, it aims to provide health insurance that acts as a supportive partner to members and their providers, improving health care experiences by addressing challenges in member and provider interactions.

• About the Opportunity:

The Member & Provider Care Specialist plays a critical role in resolving complex issues affecting providers and members. This position serves as a subject matter expert and a liaison between operational and strategic teams, supporting internal training and communications. The specialist ensures accurate workflows and case management, contributing to overall improvements in member and provider services.

• Responsibilities:
• Handle inbound and outbound communications with members and providers
• Manage assigned caseload and queue using dashboard tools
• Identify, investigate, and resolve issues within established service levels
• Collaborate to identify trends and obstacles affecting service
• Utilize internal tools and resources effectively
• Communicate findings and resolutions to providers and internal teams
• Support representatives with complex issues, workflows, and training
• Escalate updates or corrections to the internal knowledge management system
• Partner with production teams to enhance member and provider experiences
• Ensure compliance with applicable laws and regulations
• Perform other duties as assigned
• Requirements:
• Minimum 1 year experience in customer support, healthcare, technology, or related fields
• Experience working in fast-paced environments
• At least 6 months of member and customer service experience
• Minimum 1 year experience handling escalations in customer service

Bonus Qualifications

• Over 1 year of claims experience
• Bilingual in Spanish
• Bachelor''s degree
• High school diploma or GED
• Pay Range and Compensation Package:
• The set rate for this role is $22.00 per hour
• Eligible for employee benefits
• Monthly vacation accrual at a rate of 15 days per year
• Benefits & Perks:
• Medical insurance
• Dental insurance
• Vision insurance
• Paid parental leave
• 401(k) plan participation
• Life and disability insurance
• Paid sick time
• Paid holidays
• Paid wellness time and reimbursements

Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note RemoteHunter is not the Employer of Record (EOR) for this role. Our purpose in this opportunity is to connect exceptional candidates with leading employers. We help job seekers worldwide discover roles that match their goals and guide them to complete their full application directly through the hiring company’s career page or ATS. Apply tot his job Apply To this Job