Member Services Specialist - ONSITE

Job details

• Job title:
  
  Member Services Specialist - ONSITE
• Posted: 06 February 2026
• Location:
  
  Irving, TX
• Job type:
  Permanent
• Reference: 992956

The Member Services Specialist serves as a frontline ambassador for the health plan, delivering high-quality, resolution-focused support to members, providers, and brokers across multiple lines of business. As the initial point of contact, this role extends beyond basic call handling—Specialists are trained to navigate the foundational pillars of our healthcare offerings, including the Health Exchange, US Family Health Plan, and NCHD, with a strong emphasis on first-call resolution.

Specialists develop working knowledge of benefit structures, assist callers with portal navigation and access, and begin interpreting claims activity to support both member and provider inquiries. This position blends customer service excellence with technical skill-building, offering exposure to internal systems, regulatory protocols, and cross-functional workflows. Specialists are expected to gain proficiency in core platforms used for eligibility verification, claims review, and member account management (e.g., HSP, HPS, Health Trio).

All interactions must be documented with a clear and concise recap of the call’s purpose, following prescribed workflows and audit-ready standards. This role provides a structured pathway for advancement, with progressive training in claims interpretation, premium payment processing, and multi-line service delivery, laying the foundation for future specialization and leadership opportunities.

• Serve as frontline ambassador for the health plan, delivering resolution-focused support to members, providers, and brokers.
• Assist callers with portal navigation and access; interpret claims activity to support inquiries.
• Gain proficiency in core platforms for eligibility verification, claims review, and member account management (e.g., HSP, HPS, Health Trio).
• Document all interactions with a clear recap of the call’s purpose, following prescribed workflows and audit-ready standards.
• Participate in progressive training in claims interpretation, premium payment processing, and multi-line service delivery for career growth.

• Experience in frontline customer service or call center support is preferred.
• Ability to navigate healthcare-related portals and interpret basic claims information.
• Proficiency with systems used for eligibility, claims, and member account management (e.g., HSP, HPS, Health Trio) is desirable.
• Strong communication skills and attention to detail; ability to document interactions clearly.
• Willingness to engage in structured training and develop across multiple service lines.

Dexian stands at the forefront of Talent + Technology solutions with a presence spanning more than 70 locations worldwide and a team exceeding 10,000 professionals. Dexian is an Equal Opportunity Employer that recruits and hires qualified candidates without regard to race, religion, sex, sexual orientation, gender identity, age, national origin, ancestry, citizenship, disability, or veteran status.