Medical Network Customer Care Representative

Texas Mutual Insurance Company; Austin (TX); Hybrid; USD 32,000 - 39,000; Full time

Benefits offered by this job

Annual performance bonus

Employer 401(k) match

Day-one health, Rx, vision & dental

Job summary

Texas Mutual Insurance Company in Austin, TX is seeking a Medical Network Customer Care professional to answer inbound calls and emails, locate in-network providers, schedule appointments, and resolve inquiries within our workers’ compensation network. You will also help maintain provider information through credentialing activities and audits.

Preferred candidates will be bilingual in English and Spanish and have strong communication skills to support policyholders, injured workers, and

Qualifications

• High school diploma or equivalent.
• At least two years of related work experience.
• Minimum typing speed of 40 words per minute.

Responsibilities

• Answer phone calls and emails from injured workers, policyholders, agents, providers, and other partners and resolve moderately complex to complex inquiries related to our workers’ compensation network.
• Use online systems to locate in-network providers, schedule appointments, and approve requests for out of network treatment.
• Send notification letters to customers when coverage changes occur.
• Enter complaints for network grievances into internal database.
• Manage credentialing of medical providers or groups for participation in our network.
• Update our network's online provider directory with physician photos and biographies.

Skills

Typing 40 WPM

Phone & Email Support

Credentialing

Bilingual (English/Spanish)

Education

High school diploma or equivalent

Job description

We’re excited you’re considering joining a great place to work! Texas Mutual is deeply committed to creating and maintaining an environment of mutual respect and is proud to be an equal opportunity employer. All qualified applicants are encouraged to apply and will receive consideration for employment without regard to age, race, color, national origin, religion, sex, gender identity, sexual orientation, genetic information, veteran status, or any other basis protected by local, state, or federal law.

About this Position

At Texas Mutual, we're working to create a stronger, safer Texas. That means helping injured workers return to a productive life, empowering businesses to excel, and giving back to our communities. In the role of Medical Network Customer Care, you can play a role in these efforts by answering inbound calls and emails to assist injured workers, policyholders, agents, providers, and other partners, in locating network providers, scheduling appointments and resolving inquiries to our workers’ compensation network. You would also ensure our online provider information is current through credentialing efforts and audits.

Responsibilities & Qualifications

Your Goals:

• Answer phone calls and emails from injured workers, policyholders, agents, providers, and other partners and resolve moderately complex to complex inquires related to our workers’ compensation network.
• Use online systems to locate in-network providers, schedule appointments, and approve requests for out of network treatment.
• Send notification letters to customers when coverage changes occur.
• Enter complaints for network grievances into internal database.
• Manage credentialing of medical providers or groups for participation in our network.
• Update our network's online provider directory with physician photos and biographies.

Required Qualifications:

• High school diploma or equivalent
• At least two years of related work experience
• Minimum typing speed of 40 words per minute

Preferred Qualifications:

• Bilingual fluency in English and Spanish

Texas Mutual Pay Transparency

The base pay range is based on the market evaluation of the job and may include pay for multiple levels. Individual base pay within the range is determined by a variety of factors, including experience, performance, education, and demonstration of skills and competencies required for each role. Base Pay Range: $22.98 - $28.39 Per Hour

Flex-Hybrid Work Environment

Texas Mutual’s flex-hybrid schedule allows you to bring your best self to work by working remotely and collaborating in the office based on business needs. All Texas Mutual employees are required to have Texas residency and travel to their designated office as needed.

Our Benefits:

• Annual performance bonus and merit-based pay increase
• Lifestyle Savings Account ($1,000 per year)
• Automatic 4% employer contribution to retirement plan
• 401k plan with 100% employer match up to 6%
• Student loan repayment matching in 401k plan
• Three weeks’ time off for vacation
• Nine paid holidays and two personal days each year
• Day one health, Rx, vision and dental insurance
• Life and disability insurance
• Flexible spending account
• Pet insurance and pet Rx discounts
• Free on-site gym, fitness classes, and health and wellness resources
• Free identity theft protection
• Free student loan repayment and refinancing consultation
• Professional development and tuition reimbursement
• Employee referral bonus
• Free onsite snacks

Texas Mutual Insurance Company is the state's leading choice for workers' compensation insurance, with over 40 percent of the market. Thousands of Texas businesses rely on us to help them control their workers' comp costs, protect their employees, and ensure their injured workers receive quality care. Preventing workplace accidents is a foundation of our mission. We have frequently been named one of the Best Companies to Work for in Texas. Our competitive salaries, award-winning benefits package, and employee recognition programs are just a few of the reasons our average employee tenure is 10 years.