Member Service Representatives - Work From Home

UnifyCX is growing and we are are looking for experienced Member Service Representatives to join our motivated and ambitious Work From Home team!

Pay and Perks:

• Base Pay: $18.00 per hour
• Location:
  This position will be Work From Home; however, you must reside in the San Antonio, TX area to be considered
• Job Type: Full Time

Hours of Operation: 7am to 7pm Monday through Fridays and 8am to 3pm on Saturdays.

Your schedule will be 8 hours within this time frame discussed during the interview process.

Additional Benefits: Unify

CX offers a comprehensive benefits package that includes health, life, vision, and dental insurance, as well as a 4% max matching 401K, and other financial opportunity options.

What Will You Do?

As a Member Service Representative
, you will be responsible for receiving, answering, and/or resolving calls. These phone calls are from insured customers and their dependents, providers and their staff, employer/group staff, and brokers. The Member Service Representative will use companies claims / eligibility database to inquire on the status of claims, , addresses, and other issues as queried by the caller. As a Member Service Representative, you are the primary source for issuing authorizations when eligible for services.

In this position, you will:

• Provide timely and accurate information to basic incoming customer calls from members, providers, and other external and internal constituents including:
  • Issuing authorizations.
  • Handling claim inquiries from providers and members.
  • Communicate the correct information regarding accessibility, claims status and other calls of a service nature.
  • Providing benefits information.
  • Process customer claims according to established department policies and procedures.
• Checking voicemail boxes and handling customer/provider requests for:
  • I.D. cards.
  • Authorizations.
  • Customer Service questions and issues.
• Fulfill rapid call volume by handling the appropriate amount of incoming calls.
• Complete Provider Relations requests for service.
• Provide timely feedback to the company regarding customer service failures and/or customer/provider concerns.
• Partner with Sales and Provider Relations to meet and exceed customers' expectations.
• Provide excellent customer service and handle all customers in a professional and courteous manner.
• Other duties as assigned by management.

Who You Are:

To be considered, candidates are expected to have the following:

• Two years customer service or call center experience.
• Two years of experience in the health care industry or insurance environment preferred.
• Strong computer and technical skills to support heavy key data entry.
• Excellent customer service skills (friendly, courteous and helpful).
• Excellent interpersonal verbal and written communication skills.
• The ability to diffuse volatile situations, share information, and educate callers regardless of customers level of understanding.
• Understanding of the health insurance or insurance industries.
• Strong execution and follow-up skills.
• Goal oriented with ability to meet production standards.
• Team orientation and ability to work effectively across functional areas of the company.
• Accurate and efficient data entry skills.
• Strong analytical skill and ability to demonstrate good judgment.
• Ability to coordinate multiple tasks and projects.
• Skilled in dealing with all customers in an efficient and effective manner.
• Bilingual English/Spanish (a plus but not required).

Who We Are:

Unify

CX is a transformative AI platform that empowers and enables teams to deliver efficient, exceptional customer experiences. We engineer superhuman customer experiences through a powerful blend of strategy, omnichannel support, analytics, and AI-driven tools like GoTalent.

AI, Voice of Customer, and automatic QA. Our outcome-based model prioritizes measurable results for more than 200 client programs serviced today. With a focus on automation, talent enablement, strategic partnerships, and strict data ethics, Unify

CX delivers scalable, personalized, and compliant solutions that create real business impact.

Unify

CX is a certified minority-owned business and an EOE employer who welcomes diversity.