Member Service Representative

Healthcare Support Staffing; Austin (TX); On-site; USD 35,000 - 50,000; Full time

Job summary

A leading national healthcare recruiting firm in Austin, Texas, is seeking an experienced Customer Service Representative. In this role, you will respond to inquiries from members and providers, research benefits, and educate providers on prior authorization. The ideal candidate will have at least 2 years of relevant experience, preferably in a Medicare or Medicaid setting, along with a high school diploma. Bilingual skills in Spanish and English are preferred. This position offers a supportive work environment with training provided.

Qualifications

• 2+ years of related experience with at least 1 year in a call center environment.
• Experience in Medicare or Medicaid preferred.
• Ability to document member issues and resolutions.

Responsibilities

• Respond to telephone inquiries from members or providers.
• Research member eligibility and benefits.
• Educate providers on authorization requirements.

Skills

Customer service experience

Communication skills

Bilingual (Spanish and English)

Education

High school diploma or equivalent

Tools

Microsoft Excel

Microsoft Word

Microsoft Access

Job description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Are you an experienced Customer Service Representative looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes” to any of these questions – this is the position for you!

Daily Responsibilities:

• Receive and respond to all telephone inquiries from members or providers
• Research and provide information regarding member's eligibility, benefits, referrals and authorizations
• Provide members with information on the Provider Network and how to contact and access providers
• Educate providers on prior authorization requirements, how to access services and other routine, non-clinical issues
• Educate providers on process of submitting outpatient treatment requests for outpatient therapy
• Initiate or fax necessary forms to providers for outpatient therapy services
• Coordinate with Provider Relations regarding contracting and/or credentialing status
• Document all members' issues and resolution in the computer systems
• Provide backup support to Data Entry team as necessary

Shift: Monday-Friday

• 2-3 weeks of training: 8am-5pm
• After training, shift would range from 10am-7pm

Qualifications

• High school diploma or equivalent
• 2+ years of related experience with at least 1 year customer service experience in a call center environment, preferably in a Medicare, Medicaid managed care or insurance environment
• Experience with Microsoft Excel, Word and Access applications preferred
• Spanish and English preferred

Additional Information

Interested in being considered?

If you are interested in applying to this position, please contact (Sheena Lagaylay, 407-965-2843) and click the Green I’m Interested Button to email your resume.

Please click APPLY for immediate consideration.