Senior Member Services Specialist
Core
Senior Member Services Specialist handling complex, sensitive member cases involving medical claims, reimbursements, and coverage issues for a fertility benefits platform.
Role type
Senior Member Services Specialist
Builds
Resolution of complex member cases and general support volume
Domain
Healthcare / Fertility benefits
Deliverable
client delivery
Required skills
Case management, claims investigation, appeals handling, COBRA administration, deductible dispute resolution, workflow navigation, stakeholder coordination, issue identification, shift flexibility
Preferred skills
Claims/reimbursement experience, fertility benefits knowledge, financial operations, Zendesk/Jira/Slack proficiency, mentoring, Spanish fluency
Responsibilities
Own complex cases from first contact to resolution, handle appeals and denied claims, manage COBRA and coverage loss cases, take calls on specialty workflows, investigate issues before replying, drive cases requiring external partners to completion, balance complex escalations with general support volume, identify recurring issues and propose solutions
Seniority
Senior, hands-on IC