Bilingual Healthcare Concierge & Member Advocate

Frontier Direct Care; Harlingen (TX); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Frontier Membership

401(k) plan

Job summary

Frontier Direct Care in Harlingen, TX is seeking a proactive Member Care Navigator to guide members through their healthcare journey with empathy and accuracy. You will be the main contact for questions about benefits, claims, referrals, and plan design, ensuring timely responses and precise information.

You’ll handle inbound and outbound calls, maintain email inboxes, and collaborate across teams to meet SLAs while improving the member experience.

Qualifications

• Bilingual Spanish & English preferred.
• Minimum 3 years of healthcare experience (MA, CNA, Concierge, Patient Navigator, Case Manager, or similar).
• Experience with patient scheduling (medical office, clinic or health system).
• Call center or high call volume office experience preferred.
• Experience handling inbound and outbound calls with SLA adherence.
• Knowledge of medical terminology.
• Knowledge of CPT/ICD-10 codes and healthcare procedures.
• Experience with claims, prior authorizations, coding/billing preferred.
• Proficient with EHR/EMR systems.

Responsibilities

• Answer inbound calls as the main contact for member and provider questions.
• Respond to inquiries about claims, appeals, referrals, benefit information, plan design, card usage, and Direct Pay casework.
• Proactively manage tasks including outbound calls to members, providers, insurers.
• Maintain email inboxes and alerts for timely responses.
• Meet or exceed performance metrics related to call coverage and case management.
• Participate in quality improvements to enhance processes and experiences.
• Engage in training and leadership meetings to stay updated.

Skills

Bilingual Spanish/English

Healthcare experience

Patient scheduling

Call center experience

EHR/EMR systems

Medical terminology

CPT/ICD-10 codes

Multi-tasking

Tools

EHR/EMR systems

Job description

Frontier Direct Care in Harlingen, TX is seeking a proactive Member Care Navigator to guide members through their healthcare journey with empathy and accuracy. You will be the main contact for questions about benefits, claims, referrals, and plan design, ensuring timely responses and precise information.

You’ll handle inbound and outbound calls, maintain email inboxes, and collaborate across teams to meet SLAs while improving the member experience.