Job Description
Job Title: Medicare Advantage Member Services Representative
Reports To: Manager, MytruAdvantage Customer Service
Our Vision
SIHO Insurance Services will be the premier healthcare delivery system administration company, known and respected for its Insurance high quality people, innovative products and outstanding services.Location Requirement: This position is based in Columbus, IN and is not eligible for remote work or relocation. Candidates must reside in or be willing to commute to Columbus.
MTA Member Services
SIHO’s Member Services Representatives assist in creating an excellent experience for SIHO’s members and their providers. The primary responsibility of this position is to respond to member’s and providers inquiries. This position mainly responds to telephonic inquiries but may also be responsible for responding to written inquiries and assisting walk-in members. This is a non-exempt position.
Brief Description of Duties:
Assist members with navigating their healthcare needs by explaining benefits, solving claim concerns, finding a doctor nearby or being their healthcare advocate
Comply with regulatory requirements while addressing customer needs which may include complex benefit questions.
Record details of inquiries, comments, complaints, and transactions.
Escalate unresolved and pending customer grievances.
Support teammates as business needs require to ensure the organization is meeting the needs of our members and providers
Strive for first call resolution while demonstrating SIHO’s dedication to proactively work to resolve members questions and concerns.
Work with partners in other departments, or to Doctors’ offices to help resolve a customer concern.
Support your teammates as business needs require to ensure we are meeting the needs of our customers.
Performs other relevant duties deemed necessary to achieve department and company-wide goals.
Traits we are looking for:
Trustworthy Empathic Proactive
Compassionate Good Listener Problem Solver
Communicator Patient Personable & Collaborative
Schedule & Work Environment:
Full-time position with hybrid work arrangement (3 days in office, 2 days remote)
Annual schedule divided into two seasons:
Peak Season (October 1 - March 31)
Team coverage required 7 days/week, 8am-9pm
Available shifts: 8am-5pm, 9am-6pm, 12pm-9pm (remote), and 10am-7pm as needed
Weekend requirement: Minimum 2 weekends per month (remote shifts 12pm-9pm or 10am-7pm)
Schedules provided one month in advance with consideration for employee preferences
Off-Peak Season (April 1 - September 30)
Monday-Friday coverage between 8am-9pm
Available shifts: 8am-5pm, 9am-6pm, or 12pm-9pm (remote)
Must work one late shift per week (either 9am-6pm or 12pm-9pm)
Minimum Skills Requirement:
Possess a passion for customer service
Excellent communications (oral and written) and strong listening skills
General knowledge and understanding of health insurance
Knowledge of Medicare Advantage is preferred, but not required
This job calls for strong emotional intelligence to proactively provide solutions, ensuring the member's health and safety
Ability to maintain attendance to support required quality and quantity of work
Professional appearance and presence
Commitment to support and maintain confidentiality in conformance to HIPAA guidelines
Required Education:
High School Diploma and 2 years of Customer service experience
Working experience of Microsoft Office or other comparable software
Note: This position supports Medicare Advantage/MyTruAdvantage products, requiring weekend availability during peak season to ensure continuous member support.
*All positions are subject to change based on the needs of the business
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
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