Remote Healthcare Member Services Rep

Pride Health; Pearland (TX); Hybrid; USD 17,000 - 21,000; Full time

Job summary

Pride Health is hiring a Hybrid Customer Service Representative to support our client’s medical facility in Pearland, TX 77584. This is a 6+ month contract assignment with the possibility of conversion or extension, and a strong entry point into a top-tier healthcare organization.

The role provides phone-based customer service for health plan members, handling benefits, eligibility, claims, and provider inquiries.

Qualifications

• Minimum 5 years of healthcare experience required, preferably in Medicare advantage.
• Strong communication, multitasking, problem-solving, and de-escalation skills.
• Ability to protect confidential member information and navigate multiple systems.
• Ability to work independently in a remote environment after training.

Responsibilities

• Assist with benefit, claims, provider, pharmacy, appeal, and grievance inquiries.
• Resolve member concerns using empathy, problem-solving, and de-escalation skills.
• Document interactions accurately while maintaining HIPAA/PHI compliance.
• Navigate multiple systems and support AEP call volume.

Skills

Healthcare experience

Customer service

HIPAA compliance

Job description

Pride Health is hiring a Hybrid Customer Service Representative to support our client’s medical facility in Pearland, TX 77584. This is a 6+ month contract assignment with the possibility of conversion or extension, and a strong entry point into a top-tier healthcare organization.

The role provides phone-based customer service for health plan members, handling benefits, eligibility, claims, and provider inquiries.