About Texas Children's HospitalFounded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area. To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org. Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
We are searching for a Senior Call Center Representative— someone who works well in a fast-paced managed care 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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Job Duties & Responsibilities
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**Bilingual Candidates Highly Preferred**