Description and Requirements

Job Title: Member Services Representative (MSCC)

Important Note

• No time off permitted during the first 90 days (training period)

Start date:

Equipment Pick Up Date:

Training first 90 days: 8:30am-5:00pm PST

Shift after training is completed: Hours between 7a-9:30pm, Sunday through Saturday

Location: This is a remote position; however the candidate must be within 1 hour of either location to pick up equipment and report onsite for any technical issues arising from home:

Position Summary

The Member Services Representative supports Kaiser Permanente members by handling a wide range of inquiries across multiple service lines, including Member Core, Member Advanced, Medicare, and Premium Billing.

This role requires strong customer service skills, the ability to manage complex inquiries, and a commitment to delivering high-quality member experiences while adhering to organizational policies and compliance standards.

Key Responsibilities

Member Support & Inquiry Handling

• Respond to incoming member and internal inquiries across multiple service areas, including:
  • Member Core: Facility inquiries, web support, ID cards, complaints, service reviews
  • Member Advanced: Eligibility, benefits, dependents, correspondence, IVR defaults
  • Medicare: Support for up to two regions
  • Premium Billing Enterprise: Billing inquiries, payments, EFT, reinstatements, tax forms (1095), escalations
• Handle complex calls related to specialized product lines or queues
• Document all interactions accurately and according to established procedures

Customer Service & Issue Resolution

• Provide professional, high-quality service to internal and external customers
• Investigate and resolve member concerns, including complaints and service recovery
• Collaborate with health plan, medical group, and facility personnel to gather necessary information
• Follow established workflows to meet member needs and service expectations

Operations & Compliance

• Maintain confidentiality and comply with all organizational policies, including Kaiser Permanente’s Principles of Responsibility
• Support department performance metrics, including:
  • Call handling efficiency
  • First call resolution
  • Complaint resolution compliance
  • Member retention
• Utilize internal systems and tools to access and relay accurate information
• Complete all required training and assessments

Required Qualifications

• Minimum 2+ years of customer service experience or experience interacting with Kaiser Permanente members
• Strong written and verbal communication skills
• Demonstrated analytical and problem-solving abilities
• Ability to think critically and resolve complex issues
• Ability to read and respond clearly, concisely, and effectively
• Working knowledge of systems used within a call center environment

Additional Requirements

• Must pass:
  • MSCC Assessment V4
  • Ongoing knowledge checks during training
• Ability to work effectively across diverse teams and departments

Preferred Qualifications

• Previous call center experience (required)
• Health insurance or healthcare experience (highly preferred)

Key Competencies

• Customer-first mindset with a focus on service excellence
• Strong attention to detail and accuracy
• Ability to multitask in a fast-paced environment
• Adaptability and continuous learning