Healthcare Member Care Navigator — Empathy-Driven Support

Frontier Direct, LLC; Harlingen (TX); On-site; USD 25,000 - 39,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Frontier Membership for you and your 1

Disability insurance: short-term &long

401(k) plan

PTO and company holidays

Job summary

Frontier Direct, LLC is seeking a dedicated Member Care Navigator to guide members through their healthcare journey. You will provide accurate benefit information, document interactions, and escalate concerns to ensure top-tier service. The role centers on empathy, precision, and patient satisfaction.

Based at our Harlingen, TX headquarters, you will manage calls, scheduling, and inquiries, leveraging EHR/EMR systems to support streamlined care coordination and improved outcomes.

Qualifications

• Bilingual Spanish and English preferred.
• 1) Minimum 3 years in healthcare (MA, CNA, Concierge, Navigator, Case Manager).
• 2) Experience with patient scheduling in medical settings.
• 3) Call center or high-volume office experience preferred.
• 4) Experience handling inbound/outbound calls with metrics.
• 5) Knowledge of CPT/ICD-10 codes and healthcare procedures.
• 6) Proficiency with EHR/EMR or ERP systems.

Responsibilities

• Answer inbound calls and serve as main contact for member and provider questions.
• Respond to claims, appeals, referrals, benefit information, plan design, and Direct Pay inquiries.
• Outreach to members and providers as needed to manage tasks.
• Monitor and respond to emails and alerts to ensure timely resolution.
• Meet or exceed performance metrics related to call coverage and case management.
• Participate in quality improvement initiatives to enhance processes.
• Engage in ongoing training and leadership meetings.

Skills

Bilingual Spanish-English

Healthcare experience

Patient scheduling

Call center experience

Medical terminology

CPT/ICD-10 codes

EHR/EMR/ERP systems

Multitasking

SLA adherence

Tools

EHR/EMR systems

Job description

Frontier Direct, LLC is seeking a dedicated Member Care Navigator to guide members through their healthcare journey. You will provide accurate benefit information, document interactions, and escalate concerns to ensure top-tier service. The role centers on empathy, precision, and patient satisfaction.

Based at our Harlingen, TX headquarters, you will manage calls, scheduling, and inquiries, leveraging EHR/EMR systems to support streamlined care coordination and improved outcomes.