What are the responsibilities and job description for the Call Center Rep 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
30665403
Job Title
Call Center Rep
Weekly Pay
821.0
Shift Details
Shift
Day - 8x5 - 09AM
Scheduled Hours
Job Order Details
Start Date
03 / 10 / 2025
End Date
06 / 14 / 2025
Duration
14 Week(s)
Job Description
Job Title : Call Center Representative
Job Specialty : Member and Provider Advocate in Managed Care
Job Duration : 14 weeks
Shift : 9am - 5 : 30pm; Training will be onsite, and the position is remote contingent upon performance.
Guaranteed Hours : 40 hours per week
Experience : 1 year of customer service experience within managed care or insurance industry, or call center experience in any industry.
License : None required
Certifications : None required
Must-Have : Knowledge of managed care, customer service, and call center desktop support applications.
Job Description :
To serve as a Member and / or Provider Advocate by possessing knowledge and understanding of the organization's processes, policies, and procedures in order to investigate, resolve, and / or facilitate resolution of simple to moderately complex issues and / or questions reported by health plan members, prospective members, healthcare providers, or other entities relating to the Managed Care Organization.
- Be the first point of contact for assistance or information regarding eligibility, benefits, authorizations, claims, referrals, and any other Member / Provider needs.
- Assist and advocate for Members and / or Providers throughout the complaint and appeal process.
- Assist Members with timely appointment scheduling.
- Support the daily operations of the health plan call center.
- Handle calls from Members / Providers seeking assistance with Member and / or Provider-related issues.
- Review systems to identify issues, conduct comprehensive research, collaborate with other departments, communicate with internal and external resources, and create appropriate responses.
- Act as a liaison and advocate for the Members / Providers.
- Gather information to support decisions or recommendations for actions needed to resolve Member / Provider questions, issues, and / or concerns.
- Interact tactfully and empathetically with Members / Providers.
- Ensure HIPAA protections by verifying the identity of all callers before disclosing Personal Health Information.
- Complete all assigned work queue tasks and / or after-hour call center vendor notifications.
- Document thoroughly, accurately, and timely in organizational systems such as MACESS or EPIC, when applicable.
- Alert team leaders of any issues or concerns needing escalation for complete resolution or indicating a larger underlying problem.
Skills Required :
Education :
Client Details
Address
6330 W Loop S
City
Bellaire
State
Zip Code
77401
Job Board Disclaimer
By applying for jobs on this website, you consent to receive daily messages from CYNET about assignments that match your profile. Email or text HELP for more info, or STOP to unsubscribe.
Your mobile info will not be shared with third parties for marketing. Standard messaging and data rates may apply.