Sr. Call Center Member Service Representative

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Full Time Orange, CA, US

2 days ago Requisition

Salary Range: $25.00 To $30.00 Hourly

Sr. Member Service Representative

Healthcare is increasingly unaffordable for many Americans. Most people believe they have two choices: increasingly expensive, restrictive employer insurance, or an ACA plan that keeps getting pricier. Many don't know there's a third, smarter option.

WeShare Health is that option.

WeShare Health
’s mission is to make healthcare simpler, more affordable, and more human. We're a nonprofit, faith-inspired healthcare sharing organization where members contribute monthly to share one another's eligible medical expenses. We're proudly not insurance, and that's the point.

Members access a national network of 1 million physicians at 30 to 60 percent less than comparable traditional insurance. Since 2018, WeShare Health has served more than 100,000 members and shared more than $50 million in medical expenses. Our purpose is clear: people before profit.

WeShare Health is led by senior executives with deep experience across for-profit and nonprofit enterprises. We’re rated 4.6 out of 5 on Google Reviews, rated 4.7 on Trustpilot by members and certified as a Great Place To Work® by our employees. If you have a bias for action, enjoy challenges, and want to challenge the status quo to make an impact in a massive industry,
WeShare Health might be the place for you!

About This Role

The Senior Member Services Representative plays a critical role in delivering an exceptional experience to our members and serves as an experienced resource within the Member Services organization.

In addition to managing inbound and outbound member interactions, Senior Member Services Representatives are responsible for resolving complex and escalated member concerns, taking ownership of cases through resolution, supporting less experienced representatives, identifying operational trends, and partnering with internal departments to remove barriers impacting the member experience.

This position requires strong healthcare knowledge, advanced problem-solving skills, sound judgment, emotional intelligence, and a high level of accountability. Senior Representatives are expected to model our“We Got You” service philosophy by taking ownership of member concerns and doing everything reasonably possible to reach a resolution.

The ideal candidate thrives in a fast-paced contact center environment, is comfortable handling difficult and sensitive situations, and consistently demonstrates leadership without requiring a formal management title.

Key Responsibilities

Member Service & Complex Issue Resolution

• Provide exceptional service to members through inbound and outbound telephone calls and other communication channels.
• Serve as a senior-level resource for complex member questions involving program guidelines, eligibility, medical needs, pharmacy needs, billing, provider access, member responsibility, sharing determinations, and correspondence.
• Handle escalated member calls and cases that require advanced research, judgment, de-escalation, or coordination across multiple departments.
• Take end-to-end ownership of complex member issues and remain accountable for driving the issue toward resolution rather than unnecessarily transferring or redirecting the member.
• Focus on achieving First Call Resolution (FCR) whenever reasonably possible while balancing accuracy, compliance, and the overall member experience.
• Research issues across multiple systems, databases, documents, and internal resources to identify the root cause of member…