Member Experience Representative
- Location: Remote (Wisconsin Residents Only)
- Job Type: Contract-to-Hire (90 Days)
- Pay Rate: $18.25/hour
Position Overview We are seeking experienced Member Experience Representatives to provide exceptional support to members, providers, customers, and brokers regarding healthcare insurance-related inquiries. This role focuses on delivering outstanding customer service while assisting with questions related to coverage, claims, benefits, billing, and authorizations.
The ideal candidate will have healthcare customer service or call center experience, strong communication skills, and the ability to navigate multiple systems in a fast-paced environment.
Responsibilities
- Answer incoming calls and email inquiries regarding:
- Coverage and benefits
- Claim status
- Billing questions
- Prior authorizations
- Insurance authorizations
- Resolve member concerns with a focus on first-call resolution.
- Research and troubleshoot complex issues while providing accurate information.
- Document customer interactions and follow‑up actions in internal systems.
- Communicate healthcare and insurance information clearly and effectively.
- Collaborate with internal departments to resolve outstanding issues.
- Escalate concerns appropriately when necessary.
- Maintain confidentiality and protect sensitive member information.
- Meet departmental performance and service standards.
Required Qualifications
- Minimum of 2 years of healthcare customer service and/or call center experience.
- Experience with:
- Commercial Insurance
- Insurance Verification
- Explanation of Benefits (EOBs)
- Prior Authorizations
- Strong verbal and written communication skills.
- Ability to de‑escalate challenging situations and provide effective resolutions.
- Strong organizational and multitasking abilities.
- Comfortable working independently and as part of a team.
- Proficiency with Microsoft Outlook, Word, and Excel.
- Ability to navigate multiple computer applications simultaneously.
Preferred Qualifications
- Medicare experience.
- Medicaid experience.
- Health plan experience.
- Previous insurance industry experience.
- Data entry experience.
- Prior call center experience.
Training and Schedule
Training Schedule (First 6-8 Weeks):
- Monday-Friday
- 8:00 AM - 4:30 PM CST
Post-Training Schedule Options:
- Monday-Friday, 8:00 AM - 4:30 PM CST
- Monday-Friday, 8:30 AM - 5:00 PM CST
Work Environment
- Fully remote position for Wisconsin residents.
- Equipment provided.
- Candidates must be willing to pick up equipment from either Menasha or Brookfield, Wisconsin. Equipment may be shipped to candidates residing more than 90 miles from either location.
- Opportunity for an onsite work stipend after six months for employees who elect to work onsite in Brookfield.
What We're Looking For
- Customer-focused professionals who enjoy helping others.
- Strong problem‑solvers with excellent listening skills.
- Individuals who thrive in a fast-paced, high-volume environment.
- Professionals committed to delivering exceptional service and maintaining accuracy.
Job Type & Location
This is a Contract to Hire position based out of Menasha, WI.
Pay and Benefits
The pay range for this position is $18.25 - $18.25/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
- 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)
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on Aug 13, 2026.
Equal Opportunity Statement
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
San Francisco Fair Chance Ordinance
Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.
Massachusetts Lie Detector
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Use of Artificial Intelligence (AI)
We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.
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