REMOTE Member Service Representative (MUST LIVE IN MASSACHUSETTS)

Published: 6/14/2022

Job Description

Member Services Representative I / II – Massachusetts Residents

Pay Range: $18–$25 per hour, depending on experience
Location Requirement: Must reside in Massachusetts
Language: English proficiency required; English/Spanish bilingual skills preferred

Position Summary

We are seeking customer-focused Member Services Representatives to support healthcare and member service programs. Representatives respond to inquiries, explain program information, assist with accessing services, and help resolve member concerns while providing professional, accurate, and timely customer service.

Opportunities are available for candidates with varying levels of relevant experience. Assignment at the Representative I or II level will depend on experience, qualifications, and program needs. More experienced representatives may support multiple programs, handle complex inquiries, and assist with training or team support.

Primary Responsibilities

Handle inbound calls and outbound follow-up to assist members, customers, providers, and other callers.
Provide information about program requirements, benefits, available services, and resources according to established guidelines.
Research questions and concerns using multiple systems, databases, and reference materials.
Resolve inquiries within the scope of the role and escalate issues requiring additional assistance.
Accurately document interactions, actions taken, and follow-up needs.
Coordinate with internal teams and external contacts, as needed, to support timely resolution of member issues.
Demonstrate active listening, empathy, clear communication, and professionalism when assisting diverse populations.
Meet established expectations for attendance, schedule adherence, service quality, accuracy, and productivity.
Participate in required training, team meetings, and quality improvement activities.
Protect confidential member and business information in accordance with HIPAA and applicable organizational and program policies.

Additional Responsibilities for Experienced Representatives

Depending on the assignment, Representative II responsibilities may include:

Handle escalated or more complex inquiries requiring additional research and coordination.
Support multiple programs and apply program-specific procedures accurately.
Assist with claims or billing-related inquiries and reconciliation activities, as applicable.
Provide guidance, mentoring, or on-the-job support to other representatives.
Assist with program updates, system testing, process improvements, and training materials.

Qualifications

Relevant experience in customer service, member services, a contact center, information and referral, or a related service role.
Healthcare, health insurance, benefits, or human services experience preferred.
Candidates with transferable customer service experience are encouraged to apply for Representative I opportunities.
Representative II candidates should demonstrate experience independently resolving more complex inquiries, navigating multiple systems, or supporting healthcare or member service programs.
Relevant college coursework, certifications, or additional education preferred.
Ability to read, write, and communicate clearly in English.
Bilingual English/Spanish proficiency preferred; language requirements may vary by assignment.
Must reside in Massachusetts and reliably work the assigned schedule. Scheduling needs may include evenings, weekends, or holidays, depending on the program.

Required Skills

Strong customer service, active listening, and interpersonal skills.
Sound judgment, attention to detail, and effective problem-solving abilities.
Ability to learn program information, follow procedures, and navigate multiple computer systems.
Strong organizational skills and the ability to manage calls, documentation, and follow-up tasks.
Accurate typing and data entry skills, with a target proficiency of at least 30 words per minute.
Basic proficiency with internet browsers, Microsoft Outlook, Word, and Excel.

#ZRPROF

\nCompany Description

We are the experts in Human Capital. It starts with a commitment to personal attention. A single point of contact from day one. That's what makes The Panther Group different. That is how we deliver results to our clients and candidates. Our focus on quality, diversity and service sets us apart. At The Panther Group, it's about attention to detail. We attract the right talent, connect job seekers with the right jobs and provide the right custom solutions because we worry about the little things. Providing our clients the best value for their dollar, finding our job seekers opportunities where they can thrive, giving our clients and candidates the level of service they deserve, leveraging the most efficient processes in the industry.