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Member Service Representative
Chicago, IL 60608 US
Job Description
- Answer incoming calls from members/plan participants, medical providers, vendors, and partners for all health plans
- Provide excellent quality service by following call center phone scripts, policies, and procedures aiming to resolve matters on the first call
- Clear documentation, logging each inquiry, call type, referral code and supporting information into the benefit administration system
- Ability to work in a high call volume environment and provide quality in-person assistance to plan participants who walk-in for support
- Handle and resolve any open issues received via voicemail or postal mail
- Liaise non-English speaking plan participants who need support using a language line
- Meet required call center quality metrics
- Enroll eligible members into the appropriate health plan based on the guidelines of the summary plan descriptions
- Comprehensive working knowledge and resourceful use of summary plan descriptions to differentiate between 21 different health plans
- Process enrollment with accurate data entry into the benefit administration system via phone enrollment or application form
- Provide accurate benefit plan information to all members and medical providers; understand the differences in plan benefit options
- Educate members on eligibility requirements, covered/non-covered services, plan options and benefits, and best healthcare practices
- Provide members with status on their medical claims and advise members of their benefits and appeal rights
- Provide pre-service benefit, basic claim information, and patient responsibility to providers based on the participants’ selected plans
- Attend and participate in various meetings
- Create one-on-one agendas using the POP/Agenda Model and take notes based on the Standardized note taking process.
- Back-up all duties as needed.
- High school diploma or GED
- Customer service certification preferred
- 2+ years of customer service experience in the healthcare, preferably in benefits
- administration; 2+ years of call center experience
- Ability to articulate basic enrollment, benefits and eligibility information and deliver high quality customer service
- Meet or exceed 97% call handle ratio for quality and production standards
- Ability to type 35 words per minute accurately
- Intermediate user of desktop computers, laptop computers, printers, copiers, scanners, fax machines and other office equipment
- Basic skills in Microsoft Office products (Word, Excel and Outlook); Intermediate skills preferred, including Power Point
- Excellent written and verbal communication skills
- Excellent interpersonal skills at all levels of business, including effectively communicating with peers, leads, managers, executives, and external partners
- Strong listener and attention to detail
- Creative thinking and effective problem-solving skills
- Excellent people skills and customer service orientation
- Must be well organized and detail oriented
- Must demonstrate effective time-management, punctuality and ability to meet deadlines
- Must have the ability to work independently and within a team environment
- Strong accountability, with the ability to manage up laterally and work cooperatively
- Exercise clear and concise judgment
- Ability and willingness to assist in special projects and handle multiple tasks
- Comprehensive health benefits (medical, dental, and vision), generous holidays, PTO, and pension retirement plan when hired full-time by the client
- Hybrid work environment with strict protocols in place for COVID safety and security in the office
- Easy access from the orange line with a 5-minute walk or bus stop located on the same block
- Company rewards and recognizes hard work and offers continuing education opportunities
- During your employment with ExecuTeam Staffing, you are eligible to enroll in our benefits program including medical (3 plans to choose from), dental, disability, critical illness, life, vision, accident and behavioral health insurance. Additional benefits including 401K, direct deposit and our referral bonus program!
Meet Your Recruiter

Ilana Cousineau
Staffing Consultant
With 5 years of staffing experience, Ilana joined ExecuTeam in 2022 as a staffing consultant. She was responsible for overseeing store team recruitment, talent development, operational process, and growing sales. As a leader of full-cycle recruitment, Ilana is skilled in finding talent, processing background checks and I-9s, and managing new employee onboarding. Her greatest personal achievement is taking a failing sales department, hiring an entirely new team, and a year later becoming a top 5 performing team in the country. Hard-working and compassionate, Ilana speaks fluent Russian and Lithuanian languages.
Ilana is an avid fan of artistic gymnastics and hopes to attend a gymnastics competition at the summer Olympics.
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