MSR II

Member Service Representative

Location: Sacramento, CA

Schedule: Full-time (Onsite)

Contract-to-hire

Overview

We are seeking a dedicated and customer-focused Member Service Representative to support members across a variety of healthcare plans. This role is responsible for delivering high-quality service through multiple communication channels while resolving complex member issues and ensuring a seamless member experience.

Responsibilities

• Respond to member inquiries via phone, email, chat, and fax, providing accurate information on benefits, coverage, policies, and plan details

• Provide in-person support for walk-in members as needed

• Handle and resolve complex or escalated issues, including those requiring research, investigation, or coordination across departments or external partners

• Assist members, providers, brokers, and plan partners with claims and billing-related inquiries

• Accurately document all interactions, including appeals and grievances, in accordance with departmental protocols

• Educate members on available resources, including online self-service tools and programs

• Partner with internal teams to ensure timely resolution of member concerns within established service standards

• Support urgent or sensitive cases, including those related to access to care or escalations to Member Relations

• Identify and report system issues or call trends to leadership

Team Support & Collaboration

• Provide guidance and support to other Member Service Representatives on plan details, policies, and system navigation

• Assist with training, onboarding, and call shadowing for new team members

• Participate in team meetings, system updates, and process improvements

• Collaborate cross-functionally to enhance service delivery and member satisfaction

Qualifications

• 2+ years of customer service or call center experience, preferably in healthcare or insurance

• Strong understanding of healthcare plans, benefits, and member services (Commercial, Exchange, Individual preferred)

• Experience handling complex member issues, claims inquiries, or escalations

• Excellent communication skills across phone, written, and in-person interactions

• Ability to manage sensitive or emotional situations with professionalism and empathy

• Strong attention to detail with accurate documentation skills

• Proficiency with computer systems and ability to learn internal platforms quickly

Ideal Candidate

• Customer-focused, patient, and solution-oriented

• Thrives in a fast-paced, high-volume environment

• Strong problem-solver with the ability to navigate complex situations

• Collaborative team player who enjoys supporting others

Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs.  Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.

Pay Details: $22.00 to $24.00 per hour

Search managed by: Savannah Mckillip

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.

Equal Opportunity Employer/Veterans/Disabled

Military connected talent encouraged to apply

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

• The California Fair Chance Act
• Los Angeles City Fair Chance Ordinance
• Los Angeles County Fair Chance Ordinance for Employers
• San Francisco Fair Chance Ordinance

Massachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.