About Texas Children's HospitalThe 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
We are searching for a Senior Call Center Representative— someone who works well in a fast-paced setting. In this position, you will serve as a member and/or provider advocate that understands the organization's processes, policies, and procedures to investigate, resolve and/or facilitate the resolution of simple to complex issues/questions. You will be the first point of contact for assistance or information regarding eligibility, benefits, authorizations, claims, referrals and/or any other member/provider demands. Lastly, you will assist and advocate for members and/or providers throughout the complaint and appeal process and support members with timely appointment scheduling.
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