• Member Service Representative

    Robert Half Office Team (Los Angeles, CA)


    Description We are looking for a dedicated Member Service Representative to join our team in Los Angeles, California. In this role, you will serve as the primary point of contact for members, assisting with medical claims and billing inquiries while ensuring exceptional customer service standards. This is a Contract-to-permanent position, offering an excellent opportunity to contribute to a dynamic healthcare organization.

    Responsibilities:

    • Communicate with members to address inquiries regarding medical claims, Explanation of Benefits (EOBs), and billing concerns.

    • Investigate and resolve disputed claims by collaborating with internal teams and external stakeholders.

    • Review patient bills and medical records to verify accuracy and identify discrepancies.

    • Coordinate with healthcare providers to clarify or obtain missing information required for claim processing.

    • Maintain comprehensive knowledge of company policies, procedures, and health plan benefits to provide accurate guidance.

    • Implement problem-solving strategies to recommend solutions for billing, claim, and eligibility issues.

    • Follow up with members to provide updates on claims and gather any additional information needed.

    • Ensure confidential and accurate documentation of all member interactions.

    • Utilize critical thinking skills to streamline processes and improve claim resolution efficiency. Requirements • A Bachelor’s degree in a relevant field is preferred.

    • Prior experience in healthcare, insurance, or medical claims is highly desirable.

    • Outstanding communication and customer service skills.

    • Proficiency in Microsoft Office Suite, including Excel and Outlook.

    • Familiarity with CRM tools and systems such as IBM AS/400.

    • Knowledge of medical coding, billing procedures, and healthcare insurance policies.

    • Ability to prioritize tasks and excel in a fast-paced work environment.

    • Strong attention to detail and problem-solving abilities. TalentMatch®

    •Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.

     

    Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more.

     

    Robert Half will consider for employment qualified applicants with arrest or conviction records in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

     

    • 2025 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to Robert Half’s Terms of Use (https://www.roberthalf.com/us/en/terms) .