Call Center Representative-Remote jobs Freelance

Call Center Representative

Pride Health is hiring a Call Center Representative to support our client’s medical facility based in Texas.

This is a 3-month contract with the possibility of an extension with competitive pay and benefits and a great way to start working with a top-tier healthcare organization!

Training will be onsite and once cleared the position in Remote contingent upon performance.

Location – Houston, Texas (77401)

Length of Assignment – 3 Months (Possibility of Extension)

Pay Range – $18 – $22 an hour

Shift and Schedule – 9am-530p-Training will be onsite and once cleared the position in Remote contingent upon performance

Job Summary

To serve as a member and/or Provider Advocate by possessing knowledge and understanding of the organization’s processes, policies, and procedures to investigate, resolve, and/or facilitate resolution of simple to moderately complex issues and/or questions reported by the client’s members, prospective members, healthcare providers, or other entities relating to the client Managed Care Organization. To be the first point of contact for assistance or information regarding eligibility, benefits, authorizations, claims, referrals, and/or any other Member/Provider needs. To assist and advocate for Members and/or Providers throughout the complaint and appeal process. To assist Members with timely appointment scheduling.

Job Duties

• Verifies member eligibility through THMP and provides support for this activity for the Call Center Representatives, as needed.
• Acts as a secondary resource to Call Center Representatives in the absence of the Team Lead. Responds to escalated calls as appropriate and triage to Management, if necessary.
• Assists with processing workflow queues i.e., urgent requests to ensure timely submittal as requested by the Team Lead.
• Assists with onboarding of new hire employees after training in a Nesting environment. Provides the opportunity for job shadowing and mentorship.
• Completes and manages Pharmacy queue / Right Fax.
• Assists members/providers with billing inquiries and resolves member/provider billing issues.

Requirements

• HS. Diploma or GED- Required.
• 3 Years Customer service experience within managed care or insurance industry Or Call center experience within any industry- Required.
• Bilingual (English-Spanish) preferred.
• Knowledge of managed care, Medicaid, call center desktop support applications, customer relations techniques and
• general computer literacy.
• Benefits, claims processing, or membership knowledge are preferred.
• The ability to work well with the public adopt a customer perspective and work well individually and in a team
• environment
• Effective interpersonal skills and phone etiquette are required
• Strong verbal communication skills
• Good listening skills
• Knowledge of medical terminology
• Problem identification and problem-solving skills and ability to multitask
• Technical Skills: Typing, 35 WPM

Benefits

Pride Global offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.

Equal Opportunity Employer

As a certified minority-owned business, Pride Global and its affiliates – including Russell Tobin, Pride Health, and Pride Now – are committed to creating a diverse environment and are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics.