Senior Member Services Specialist

Location: Remote within specified US states: Arizona, District of Columbia, Delaware, Florida, Georgia, Hawaii, Illinois, Kansas, Massachusetts, Maryland, Maine, Michigan, Minnesota, Missouri, North Carolina, New Jersey, New Mexico, Nevada, New York, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Vermont, and Wisconsin. Active US work authorization is required. Available shifts are scheduled in EST and may include evenings, overnights, weekends, and holidays.

Salary: $82,000–$96,000 per year, plus equity and benefits.

Company

hirify.global provides virtual healthcare and women's and family health programs through employer, health plan, and consumer platforms.

What you will do

• Own complex and sensitive member cases from first contact through resolution, including appeals, denied claims and applications, coverage loss, COBRA, deductible disputes, reimbursement issues, and urgent care needs.
• Handle specialty-workflow calls and general support requests such as appointment changes, login issues, enrollment questions, and partner programs.
• Investigate member histories, identify breakdowns, and provide accurate answers instead of status updates.
• Explain coverage, eligibility, and reimbursement rules clearly without promising outcomes outside your control.
• Coordinate with Jira, Compliance, clinics, and benefits administrators, following cases through closure and handing off with complete context.
• Identify recurring member issues and propose practical improvements while working the assigned EST shift.

Requirements

• Experience independently managing complex member or customer cases through resolution.
• Ability to investigate issues, interpret coverage and reimbursement rules, and communicate clearly in writing and by phone.
• Ability to distinguish between different workflows, escalate appropriately, and provide thorough handoffs.
• Ability to balance sensitive escalations with changing general support volume across programs and channels.
• Active US work authorization is required, and candidates must be located in one of the listed US states.
• Availability for assigned EST shifts, including evenings, overnights, weekends, and holidays, is required as applicable.

Nice to have

• Experience with claims, appeals, reimbursement, payments, fertility benefits, specialty healthcare, or financial operations.
• Experience with Zendesk, Jira, and Slack.
• Experience mentoring peers or supporting quality assurance programs.
• Spanish fluency in written and verbal communication.

Culture & Benefits

• Flexible and inclusive remote work environment with tools and collaboration support.
• Health, dental, and insurance plan options for eligible US-based full-time employees.
• Access to Maven healthcare specialists, including mental health, reproductive health, family planning, and pediatrics.
• Wellness partnerships, an annual professional development stipend, and access to a personal career coach.
• Sixteen weeks of fully paid parental leave and a new-parent stipend after one year of employment.
• 401(k) matching with immediate vesting for US-based employees.