Description We are seeking a Member Services Rep. II to join our team in Pearland, Texas, 77584-7298, United States. This role offers a long-term contract employment opportunity within the health industry. As a Member Services Rep. II, you will be responsible for providing concierge service to our members, which includes answering inquiries, making outreach calls, and promoting member retention and growth initiatives. Responsibilities: • Provide high-level customer service to callers and make outreach calls to members to provide information regarding health plan policies. • Resolve inquiries from health plan members, providers, and various customers, surpassing productivity, quality, and service standards. • Learn and implement software applications to respond to administrative issues related to health plan operations. • Handle administrative tasks related to claims resolution, premium billing, medical benefit interpretation, organization, and coverage determinations. • Manage referral inquiries, Prescription Drug inquiries, and enrollment/disenrollment activities. • Interpret and apply Medicare Policy and Procedures, including but not limited to Late enrollment penalty, low-income subsidy enrollment/disenrollment guidance, Medicare beneficiary protections, and Medicare coverage rules. • Support chat conversations and make outbound calls to assist with scheduling member appointments and to determine disenrollment reasons. • Maintain accurate customer credit records and process customer credit applications efficiently. • Monitor customer accounts and take appropriate action based on account status. • Utilize communication, documentation, and interpersonal skills to enhance customer service and ensure efficient operations. Requirements • Demonstrated proficiency in customer service, with a strong emphasis on delivering quality outcomes • Excellent communication skills, both written and verbal, to effectively liaise with team members and clients • Proficiency in documentation and recording information accurately as required by operations • Proficient in planning, scheduling and managing appointments effectively • Knowledge of procedures and policies related to member services • Experience in handling both inbound and outbound calls in a professional manner • Familiarity with insurance concepts, medical coverage, and billing procedures • Knowledge of workstation support and ability to troubleshoot basic technical issues • Experience in managing benefit functions and claim administration • Understanding of regulation and policy within the insurance industry • Ability to maintain productivity in a fast-paced environment • Proficiency in Spanish language will be an added advantage • Strong interpersonal skills to build and maintain professional relationships • Experience in conducting surveys and collecting customer feedback • Familiarity with Medicare policies and procedures • Must be able to prioritize tasks and manage time effectively • Ability to work online and familiarity with digital tools for service delivery • Knowledge of quality assurance practices and ability to uphold high service standards. Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles. Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information. © 2024 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to Robert Half’s Terms of Use (https://www.roberthalf.com/us/en/terms) .