9126747 Member Services Specialist

Location: Irving, TX
Job Type: 3-Month Contract-to-Hire
Schedule: Monday – Friday, 8:00 AM – 5:00 PM
Work Arrangement: Onsite
Company: Sigma Inc.

Now Hiring: Member Services Specialist – Healthcare Customer Service

Sigma Inc. is seeking a customer-focused Member Services Specialist to join our team in Irving, TX. This is an excellent opportunity for individuals interested in healthcare customer service, insurance support, member advocacy, and call center operations.

As a Member Services Specialist, you will serve as the first point of contact for health plan members, providers, and brokers, helping them navigate healthcare benefits, claims, eligibility, coverage questions, and online member portals. This contract-to-hire opportunity offers comprehensive training, career growth potential, and exposure to healthcare operations and insurance administration.

Key Responsibilities

Customer Service & Member Support

• Respond to inbound phone calls, emails, and chat inquiries from members, providers, and brokers.
• Deliver professional, resolution-focused customer service while meeting quality and performance standards.
• Assist members with healthcare benefits, coverage questions, eligibility verification, and plan information.
• Guide members through healthcare services, provider networks, and pre-authorization requirements.
• Educate members on their rights, responsibilities, and available healthcare resources.

Claims & Benefits Support

• Review and explain claims activity and benefit information.
• Assist with member inquiries related to insurance plans, healthcare coverage, and premium payments.
• Help members understand plan policies, procedures, and available services.
• Support inquiries across multiple healthcare lines of business, including Health Exchange, US Family Health Plan (USFHP), and NCHD programs.

Documentation & System Navigation

• Accurately document all customer interactions in CRM and member management systems.
• Maintain audit-ready records following established workflows and compliance standards.
• Utilize healthcare platforms and internal systems for eligibility verification, account management, and claims research.
• Assist members with portal access, account setup, password resets, and navigation support.

Problem Resolution

• Investigate and resolve member concerns, complaints, and escalations.
• Collaborate with internal departments to ensure timely issue resolution.
• Provide first-call resolution whenever possible to enhance member satisfaction.
• Identify opportunities for process improvements and enhanced customer experiences.

Team Collaboration & Professional Development

• Participate in training programs and ongoing professional development.
• Maintain knowledge of healthcare industry trends, insurance products, and regulatory requirements.
• Support operational excellence through teamwork and continuous improvement initiatives.

Qualifications

Required

• High School Diploma or GED.
• Strong verbal and written communication skills.
• Excellent customer service and problem-solving abilities.
• Ability to multitask in a fast-paced environment.
• Basic computer and data entry skills.
• Ability to learn new systems, processes, and healthcare terminology.

Preferred

• 0–2 years of customer service experience.
• Call center, healthcare, insurance, member services, patient services, or customer support experience.
• Experience handling inbound calls, emails, or chat support.
• Experience documenting customer interactions in CRM systems.
• Familiarity with healthcare benefits, claims, eligibility, or insurance terminology.