[Hiring] Member Support Specialist @Oakbridge Insurance Agency

Role Description

The Member Support Specialist is responsible for delivering high-quality service to members by addressing questions related to benefits, eligibility, and medical claims. This role serves as a primary point of contact for member inquiries, working closely with providers, carriers, and internal team members to resolve issues efficiently and accurately. The ideal candidate demonstrates strong communication skills, attention to detail, and the ability to problem-solve in a fast-paced environment.

• Handle inbound customer service calls regarding employer-sponsored benefit plans
• Review and investigate medical claims, coordinating with providers and carriers to ensure accurate processing and resolution of discrepancies
• Communicate benefit eligibility and explain plan provisions based on plan documents
• Assist members in understanding benefit options and navigating their coverage
• Conduct outreach to providers, clients, and carriers as needed to support issue resolution
• Document and maintain accurate call notes and activity in the tracking system
• Utilize internal systems and databases to provide timely and accurate information
• Manage time effectively while maintaining attention to detail and service quality
• Handle challenging member interactions with professionalism and escalate issues when appropriate
• Collaborate with team members to resolve complex issues and support departmental needs
• Support enrollment activities, including handling enrollment calls and assisting during peak periods such as Open Enrollment
• Participate in additional projects and tasks within the Benefits department as needed
• Build and maintain positive, professional relationships with members, coworkers, and external partners

Qualifications

• Life & Health Insurance License
• Strong communication skills with a customer-first mindset and professional phone etiquette
• Ability to troubleshoot issues with empathy, patience, and critical thinking
• Detail-oriented with strong organizational and time management skills
• Comfortable working in a fast-paced, team-oriented environment
• Basic technical aptitude and ability to navigate multiple systems and databases

Requirements

• Prior experience in customer service, benefits administration, or healthcare-related support
• Bilingual in Spanish (preferred, but not required)

Benefits

• 401k plan with immediate participation
• Company match and immediate 100% vesting
• Company-paid life insurance
• Short- and long-term disability
• Strong health insurance plan with many supplemental, voluntary offerings