Team1Medical
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USD
20
25
HOUR
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Olivia Gonzalez, CHP
Member Services Representative II
Posted: 08/21/2023
2023-08-21
2023-10-20
Industry: Clerical/Office
Job Number: OG73605821
Pay Rate: $20-25 / hour
Job Description
Member Services Representative II
Zip Code: Pearland, TX 77584 | Location: Highway 288 South Area
Employment Type: Temp-to-hire | Workplace Type: On-site
Healthcare Specialty: Billing Services | Salary: $20 - $25 an hour
Team1Medical Staffing is partnering with one of Houston’s recognized healthcare organizations in seeking a Member Services Representative II that will provide a high level of service to callers and make outgoing calls to provide information regarding health plans, obtain responses to various required surveys, and promote member retention and growth initiatives. Whether it be now or later, you do not want to miss out on this opportunity. Submit your resume today and see where this opportunity will take you!
Member Services Representative II’s Responsibilities
- Resolve inquiries from health plan members, providers, and customers while consistently exceeding productivity, quality, and service standards.
- Respond to administrative issues related to health plan operations, including claims resolution, premium billing, medical benefit interpretation, organization and coverage determinations, referral inquiries, prescription drug inquiries, and enrollment or disenrollment activities.
- Manage member and provider incoming calls for the Medicare Advantage plans and demonstrate the ability to interpret Medicare Policy and Procedures, including late enrollment penalty, low-income subsidy, enrollment/disenrollment guidance, Medicare beneficiary protections, and Medicare coverage rules.
Member Services Representative II’s Qualifications
- High School Diploma or GED is required.
- A minimum of 5 years of experience in a health care or health plan insurance environment is required.
- Strong knowledge of HMOPOS and TPA Plan Design and Claims Processing is required.
- Knowledge of Health Care and insurance and the ability to Interpret/Apply CMS Regulations, Texas Department of Insurance Regulations, and ERISA is required.
- Knowledge of Health Care and insurance and the ability to Interpret/Apply Medicare Prescription Drug Benefits, Medical Benefit Interpretation is required.
- Essential computer, interpersonal, and verbal and written communication skills are required.
- Must be able to pass a pre-employment drug screening and criminal background check.
Company Culture & Perks
- Work Schedule: Monday through Friday, 8:00 am to 5:00 pm, with no weekends to offer a good life/work balance.
- Work for a healthcare organization that values patient care, customer satisfaction, and a supportive environment.
- During employment with Team1Medical Staffing, you can enroll in our benefits program, including medical (3 plans to choose from), dental, disability, critical illness, life, vision, accident, and behavioral health insurance. Additional benefits include 401K, direct deposit, and our referral bonus program!
Salary: $20 - $25 an hour
Submit your resume today and see where this opportunity will take you!
Why Team1Medical?
Team1Medical is one of the most trusted medical staffing agencies in the United States. Our team believes in the importance of learning who you are as a person and a professional. We offer Direct Hire, Temp-to-hire, and PRN positions to allow you to choose the opportunities that best fit your needs. Whether you are an experienced professional or just launching your career, Team1Medical will invest in your success. View more open positions at www.team1medical.com.
Team1Medical, A Reserves Network Company, is a family-owned and veteran-founded company. Since 1987, we have been a trusted partner to employers and job seekers within the healthcare community. As an equal-opportunity employer, we value our employees and foster an environment of respect, integrity, and trust in every aspect of employment. However you identify, and whatever your background, we encourage you to apply today.
Be sure to click on the link and apply for this opportunity today. For more information or questions, call our office at 713-590-2980.
Meet Your Recruiter
Olivia Gonzalez, CHP
Staffing Consultant
Olivia received her bachelor’s in human resources from the University of Houston. She joined Team1Medical in 2021 as a Staffing Consultant working to enrich Houston’s healthcare by matching healthcare organizations and top-notch candidates to offer the best patient care. In November 2022, Olivia earned her Certified Health Care Staffing Professional® (CHP) certification. Trustworthy, compassionate and a detailed-oriented communicator, Olivia wants to help people find a job they love. She believes that people are the most important asset to any organization and her goal is to help our candidates and clients in enriching their careers and internal resources.
In her free time, Olivia is an enthusiast of music, movies and relaxing with family and friends.
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Ready to take the next step in your career? Explore job opportunities around Pearland, Texas, a vibrant city just south of Houston, known for its bustling economy and endless growth opportunities. Nestled in the heart of the Lone Star State, Pearland offers a unique blend of southern charm and modern amenities. With easy access to the NASA Space Center, the renowned Houston Museum District, and world-class dining options ranging from classic Tex-Mex to fresh Gulf seafood, Pearland is a hub of culture and innovation. Whether you're a sports enthusiast looking to catch a game at NRG Stadium or a nature lover seeking solace at the Armand Bayou Nature Center, Pearland has something for everyone. Don't miss out on the chance to launch your career in this thriving community – explore our job listings today!