Call Center Representative - The Health Plan

 
Position: Call Center Representative - The Health Plan

Location: US-TX-Bellaire

Shift: 7am - 11p Monday - Friday; 9a - 6p Sat/Sunday

About Texas Children's Hospital

The Texas Children’s Hospital system is the largest pediatric integrated care system and is an industry leader in pediatric population health.    Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children and pregnant women.  We are an Integrated Community System providing holistic care that empowers families to live healthier lives.  Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.  Currently, the Health Plan serves more than 450,000 members across three state territories (Harris, Jefferson, North East), who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. To join our community of 13,000 dedicated team members, visit www.texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at www.infinitepassion.org

Summary:

We are searching for a Call Center Representative – someone who works well in a fast-paced setting. This position will serve as a Member and/or Provider Advocate by possessing knowledge and understanding of the organization's processes, policies, and procedures. This role will investigate, resolve and/or facilitate resolution of simple to moderately complex issues and/or questions reported by departments within the organization. You will be the first point of contact for assistance and/or information regarding eligibility, benefits, authorizations, claims, referrals and any other needs. This position will assist and advocate for members and/or providers throughout the complaint and appeal process and assist members with timely appointment scheduling.

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Responsibilities :

Job Duties & Responsibilities

 

  • Supports the organizations call center’s day to day operation
  • Educates members about their health coverage benefits and services
  • Empowers members by directing them toward available resources for self-help
  • Ensures departmental expectations for knowledge, training and outcomes are met
  • Maintains confidentiality of the member’s personal health information


Qualifications:

Skills & Requirements

 

  • H.S. Diploma or GED required
  • 1-year customer service experience within managed care or insurance industry required
  • 1-year call center experience in any industry required
  • Bilingual (English/Spanish) highly preferred, but not required

 



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