What are the responsibilities and job description for the Call Center Rep, Sr position at Texas Children's Health Plan?

Details

Client Name

Texas Children's Health Plan

Job Type

Travel

Offering

Non-Clinical

Profession

Non-Clinical

Specialty

Customer Service Rep

Job ID

30421902

Job Title

Call Center Rep, Sr

Weekly Pay

909.0

Shift Details

Shift

Day - 8x5 - 09AM

Scheduled Hours

Job Order Details

Start Date

02 / 24 / 2025

End Date

05 / 24 / 2025

Duration

13 Week(s)

Job Description

Job Title : Call Center Representative, Senior

Job Specialty : Member Services - Inbound

Job Duration : 13 months

Shift : 9am-5 : 30pm (Training will be onsite; remote work contingent upon performance)

Guaranteed Hours : 40.00 hours per week

Experience : 3 years of customer service experience within managed care or the insurance industry, or call center experience within any industry

License : Not specified

Certifications : Not specified

Must-Have :

Knowledge of managed care and Medicaid
Call center desktop support applications proficiency
Customer relations techniques
General computer literacy
Effective interpersonal skills and phone etiquette
Strong verbal communication skills
Good listening skills
Knowledge of medical terminology
Problem identification and problem-solving skills
Ability to multitask
Typing, 35 WPM
Bilingual (English-Spanish) preferred

Job Description :

Serve as a Member and / or Provider Advocate by possessing knowledge and understanding of the organization's processes, policies, and procedures.

Investigate, resolve, and / or facilitate resolution of simple to moderately complex issues and / or questions reported by members, prospective members, healthcare providers, or other entities.

Be the first point of contact for assistance or information regarding eligibility, benefits, authorizations, claims, referrals, and other Member / Provider needs.

Assist and advocate for Members and / or Providers throughout the complaint and appeal process.

Assist Members with timely appointment scheduling.

Verify member eligibility and provide support for call center representatives, as needed.

Act as a secondary resource to call center representatives in the absence of the team lead.

Respond to escalated calls as appropriate and triage to management, if necessary.

Assist with processing workflow queues, ensuring timely submittal as requested by the team lead.

Assist with onboarding of new hire employees after training in a nesting environment, providing opportunities for job shadowing and mentorship.

Complete and manage pharmacy queue / Right Fax.

Assist members / providers with billing inquiries and resolve member / provider billing issues.

Client Details

Address

6330 W Loop S

City

Bellaire

State

Zip Code

77401

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