Founded in 2013 by Texas Children's Health Plan, The Center for Children and Women is a NCQA recognized patient and family-centered medical home that provides enrolled Texas Children's Health Plan members the highest quality community-based health care, education, and advocacy. We have two locations at Greenspoint and Southwest Houston.
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.
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.
Think you've got what it takes?
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
Skills & Requirements
- High School Diploma or GED required
- 1-year customer service experience within managed care or insurance industry required or
- 1-year call center experience in any industry required
- Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees at Texas Children's, unless approved for a medical or religious exemption
