Texas Licensed Health Plan Representative

Job Summary

A company is looking for a Health Plan Contact Center Representative to support member and provider inquiries.

Key Responsibilities

• Answer incoming calls and assist customers with inquiries related to benefits, eligibility, billing, and authorizations
• Document call details accurately and provide informed responses to callers
• Research complex issues and ensure resolution while maintaining confidentiality of protected health information (PHI)

Required Qualifications

• High School Diploma / GED
• 1+ year of customer service call center experience with a payer
• Familiarity with computer applications and ability to learn new systems
• Knowledge of payer healthcare terminology and documents
• 1+ year experience with healthcare claims and/or eligibility data