Job Description

At ElevaIT, we’re currently looking for a Member Services Representative for a 2+ Months Contract with our direct client —and I think you might be a great fit!

Job Title: Member Services Representative

Location: Fountain Valley, CA 92708 (Hybrid)

Duration: 2-3+ Months

Job Type: Contract

Note : Top 3 Keywords: 1- Managed Healthcare/Health Plan Customer Service 2. Member Grievances & Appeals Processing 3. Specialty Coding Certification

Top Required Skills

• Customer Service & Member Support
• Call Center/Transaction Processing
• Communication & Documentation

Must-Have Skills:

• Minimum 2 years of experience in a transaction-based or call center environment
• Strong verbal and written communication skills
• Ability to build rapport and demonstrate empathy with members
• Basic computer skills (MS Word, Excel)
• Typing speed of 45 WPM
• Ability to multitask and meet productivity and quality standards
• Attention to detail and strong organizational skills
• Ability to maintain confidentiality (HIPAA compliance)

Key Responsibilities and Duties:

• Serve as the primary point of contact for members via phone, email, internet, and written correspondence
• Document and track member, provider, and sponsor interactions accurately
• Educate members on benefits, policies, rights, and responsibilities
• Process member grievances, appeals, and service requests
• Support multiple service queues (Claims, Medical Management, Provider Services)
• Review member claims history to ensure accurate benefit tracking

Requirements:

• High School Diploma or GED (required)
• 2+ years of call center or transaction-based experience
• Typing speed of at least 45 words per minute
• Basic proficiency with Microsoft Word and Excel
• Specialty coding certification (required)

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