Harris Health System

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Member Services Rep II

at Harris Health System

Posted: 9/24/2019
Job Status: Full Time
Job Reference #: 146248
Keywords: medical

Job Description

About Us

Community Health Choice, Inc. (Community) is a non-profit Health Maintenance Organization (HMO) licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 70 hospitals, Community serves over 260,000 Members with the following programs:

• Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

• Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

• Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Job Profile

The Member Service Rep l is responsible for accomplishing their primary goal of providing support and rendering excellent customer service by addressing all Health Plan Members calls related to inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation and the status of authorizations for medical care. Serving assistance to a minimum of 2 Lines up to all lines of business and maintaining confidentiality per HIPAA guidelines.

QUALIFICATIONS:

  • High School Diploma or GED
  • Two years member/customer service experience in a Managed Care Call Center.

SPECIAL REQUIREMENTS:

  • Bilingual Skills Required? Yes
  • Languages: Spanish/Vietnamese

SKILLS:

  • Analytical
  • Research
  • Statistical
  • P.C., MS Word
  • Writing /Composing/Correspondence/Reports
Benefits and EEOC

Community employees’ benefits are provided by Harris Health. These benefits are designed to provide you with flexibility and choices in meeting your specific needs.

Community is an Equal Opportunity Employer.

Job Category

CHC Call Center Operations

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!