Bilingual Member Care Navigator - Patient Experience

Frontier Direct Care, LLC; Harlingen (TX); On-site; USD 42,000 - 56,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Frontier Membership for you and yourim

Voluntary disability and life insuranc

401(k) plan

PTO with up to 5 unplanned days per yr

9 company holidays

Parental leave

Job summary

Frontier in Harlingen, TX is hiring a Member Care Navigator who acts as the trusted main contact for members, guiding them through their healthcare journey with empathy and accuracy. You will provide timely information on benefits, explain CPT/ICD-10 codes, and document interactions using EHR systems.

The full-time role requires bilingual Spanish/English capabilities, healthcare experience, and strong multitasking across multiple systems and workflows while meeting SLAs.

Qualifications

• Minimum 3 years in a healthcare setting (e.g., Medical Assistant, CNA, Concierge, Patient Navigator, Case Manager)
• Experience with patient scheduling in a medical office/clinic
• Call center or high-volume office experience preferred
• Experience handling inbound/outbound calls with call metrics
• Working knowledge of CPT/ICD-10 codes and healthcare procedures/regulations
• Proficiency with EHR/EMR or similar ERP systems required
• Ability to multitask across multiple systems and workflows while meeting SLAs

Responsibilities

• Answer inbound calls and serve as the main point of contact for member and provider questions
• Respond to inquiries related to claims, appeals, referrals, benefits, plan design, card usage, and Direct Pay casework
• Proactively manage assigned tasks including outbound calls to members, providers, and insurers
• Maintain assigned email inboxes and alerts for timely responses
• Meet or exceed performance metrics related to call coverage, attendance, and case management
• Participate in quality improvement initiatives to enhance processes and member experiences
• Engage in ongoing training and leadership meetings to stay current with updates and system changes

Skills

Bilingual (Spanish & English)

Call center experience

Patient scheduling experience

Medical terminology knowledge

EHR/EMR proficiency

Tools

EHR/EMR software

ERP systems

Job description

Frontier in Harlingen, TX is hiring a Member Care Navigator who acts as the trusted main contact for members, guiding them through their healthcare journey with empathy and accuracy. You will provide timely information on benefits, explain CPT/ICD-10 codes, and document interactions using EHR systems.

The full-time role requires bilingual Spanish/English capabilities, healthcare experience, and strong multitasking across multiple systems and workflows while meeting SLAs.