Healthcare Member Services Rep

Member Services Representative
- Healthcare Support Specialist
- Call Center Customer Service

• Location: Houston, TX (zip code 77081)
• Pay Rate: $19.69/hour
• Assignment Length: 3-month assignment with potential for extension based on business needs and performance
• Interview Dates: Interviews will be conducted on August 11, 12, 13 only
• Schedule: Monday through Friday, full-time daytime hours
• Work Environment: Fully Onsite
• Employment Type: Full-Time, Contract Assignment
• Industry: Healthcare Services / Member Support / Contact Center Operations

Position Overview

We are seeking a dedicated and service-driven Member Services Representative to join a fast-paced healthcare support team in Houston. This role serves as the primary point of contact for members, providers, and partners by handling inbound inquiries related to healthcare benefits, eligibility verification, claims status, authorization updates, and general account support.

Required Qualifications

• High school diploma or GED required
• Minimum of 2 years of customer service or call center / contact center experience
• At least 1 year of healthcare-related experience supporting benefits, claims, eligibility, or authorizations preferred
• Strong working knowledge of Microsoft Office including Word, Excel, and Outlook
• Ability to work independently with minimal supervision
• Strong data entry accuracy and moderate to advanced computer proficiency
• Excellent written and verbal communication skills
• Strong problem-solving ability with attention to detail
• Ability to manage multiple priorities in a fast-paced environment

Key Responsibilities

• Manage incoming calls related to member benefits, eligibility verification, claim status updates, prior authorizations, and service concerns
• Research and resolve claims-related inquiries by identifying issues, reviewing claim details, and determining appropriate next steps
• Submit reconsideration requests and escalation documentation when necessary
• Provide first-call resolution whenever possible to ensure a positive customer experience
• Accurately document all interactions, updates, and follow-up actions within internal CRM and case management systems
• Route inquiries electronically to the appropriate departments while maintaining complete and accurate records
• Track recurring issues and communicate trends to leadership for operational improvements
• Maintain compliance with privacy standards, confidentiality requirements, and internal service protocols
• Collaborate with internal teams including claims, eligibility, authorizations, and operations support to ensure timely issue resolution
• Deliver professional, courteous, and solution-focused service in every interaction

Preferred Experience

• Experience supporting healthcare plans, insurance operations, or managed care environments
• Familiarity with claims review, eligibility verification, and authorization workflows
• Experience working within CRM systems and healthcare service platforms
• Strong understanding of confidentiality standards and compliance requirements

Core Competencies

• Customer service excellence
• Analytical thinking
• Attention to detail
• Strong interpersonal communication
• Professional written communication
• Responsiveness and sensitivity
• Reliability and accountability
• Team collaboration
• Adaptability and problem-solving

Throughout the past 30 years plus, MMC, one of the most trusted names in workforce management services, has successfully delivered strategic solutions to large and small businesses in numerous industries.

We have built our reputation on partnering with our clients and candidates to achieve the desired results. Our recruiting professionals have extensive experience matching the right candidate, to the right client, for the right position. We provide the best opportunities to the most talented candidates in a multitude of industries.

MMC is a privately owned business with corporate headquarters in Irving, Texas. With