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Member Specialist


This is a Full-time position in Houston, TX posted June 22, 2021.

This role is a customer service position with the purpose of working with members to successfully obtain all pertinent information to be able to have them matched with the appropriate legal representation. This role works in a call center environment handling inbound and outbound calls from and to members and providers. This role works in a team environment and is expected to consistently maintain metrics/KPI’s as defined by management.Answer incoming emails in a timely manner as defined by the Service Level Agreements. Quickly determine the caller’s needs and proceed to handle the intake of information and assist the caller. Confirm eligibility when necessary and verify plan benefits. Complete a thorough and accurate case profile during intake. Ensure that the member has a clear and correct understanding of benefits and process before ending the initial call. Attempt to create comfort zones with each member. Work with the team to proactively solve issues. Communicate effectively and in a timely fashion with customers, teammates, and management. Complete a Daily Status Updates when referrals are not ready the same day or the next day, so that the information can be communicated to the member. Provide Referral information to the member within 30 minutes of completion. Use every available contact method to provide the referral to the member. Follow up with the members until it can be confirmed that the member has had a consultation using the Follow-up Guidelines when you are unable to reach the member. Ensure that the member was satisfied with the consultation and determine whether the member will use the Provider’s services, would prefer another Provider, or has received all necessary services. Continue following up with the member until the Providers are completed to ensure satisfaction, at each touch point, proactively and after. Report all issues, concerns, complaints and potential problems with Members or Providers using the Escalations Procedures. Respond to all phone messages and emails within two (2) business hours. Report daily activity, using the standard Daily Report format. All other duties as assigned.

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