Member Services Agent I

Job Description

Job Description

We are seeking a dedicated and highly customer-focused Member Services Agent I to join our healthcare organization. This role is responsible for handling member inquiries with professionalism, accuracy and empathy to ensure a seamless and high-quality customer experience. The ideal candidate will have exceptional problem-solving skills, a passion for service excellence and a commitment to delivering personalized and effective solutions through clear communication and responsiveness.

Responsibilities :

• Outbound outreach to members who may or may not have heard of Vida via our phone system. Use Motivational interviewing and rapport building to explain the benefits of enrollment into Vida’s program, which is free to the member.
• Take in-bound calls from members to conduct assessments, answer questions related to services, assist with program enrollment based on interests and health goals and help members with app navigation, general inquiries or status updates related to prior phone or email interactions.
• Provide an exceptional customer experience by responding to member inquiries with professionalism, empathy and efficiency, while proactively identifying opportunities to educate and promote Vida program offerings that best meet member needs.
• Accurately document all member interactions and resolutions in the Member Services system, following established processes to maintain service integrity and transparency ensuring member confidentiality at all times according to HIPAA regulations.
• Proactively resolve member concerns by identifying solutions and escalating complex issues to the appropriate departments while ensuring timely follow-up and resolution with the member.
• Adhere to company protocols to ensure compliance with healthcare standards while prioritizing member satisfaction and quality service delivery, effectively addressing concerns and overcoming objections to provide clear, informed and reassuring solutions or program offerings.
• Support Member Services projects on an ad-hoc basis, including updating training, leading peer sessions or team meetings, brainstorming scripting improvements and quality monitoring working collaboratively with team members to enhance service quality, streamline processes and contribute to a culture of continuous improvement.
• Engage in ongoing training and professional development to sharpen service skills and stay informed on industry best practices.
• Champion the organization’s commitment to excellence by creating a welcoming, solutions-driven and member-focused service environment, ensuring that every member receives accurate, reliable and high-quality support.
• Consistently meet and exceed inbound and outbound Key Performance Indicators (KPIs) as well as other duties as assigned, demonstrating a commitment to responsiveness, accuracy and service excellence.

Qualifications :