28 Member service representative Jobs in Pearland, TX
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Kelsey-Seybold Clinic is Hiring a Member service representative Near Pearland, TX
Responsibilities
Managed Care Representatives respond to inquiries from health plan members, providers and various customers while consistently meeting productivity, quality and service standards.
Representatives utilize various internal and external software applications to provide Concierge type services related to health plan operations including benefit interpretation for providers, claims resolution, referral inquiries, general plan benefits, Kelsey-Seybold Clinic information, and enrollment eligibility.
Managed Care Representatives handle member and provider calls for self-funded, fully insured and Medicare Commercial plans.
Job Title : Managed Care Representative II Member Services
Clinic Location : Pearland Administrative Office
Department : Member Services
Job Type : Full Time
Salary Range : $41,880 $51,725 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)
Qualifications
Education
Required : High School Diploma
Preferred : Associate or bachelor’s Degree
Experience
Required : 2 year experience in a health care or insurance environment
Knowledge of health care and insurance industries and health care delivery systems
Knowledge of Texas Department of Insurance and ERISA Regulations
Excellent interpersonal skills to interface with physicians. Strong ability to actively listen to customers, probe for clarification, and provide consultative guidance based upon customers inquiries.
Ability to use a variety of software applications
Analytical skills to evaluate problems and recommend alternative solutions
Preferred : Previous experience with a call documentation system
Knowledge of Medical Terminology
Ability to Work in a Fast Paced Continuously Changing Environment
Knowledge of CPT and ICD9 Codes
Ability to understand complex oral and written directions and technical information.
License(s)
Required : N / A
Preferred : N / A
Special Skills
Required : Strong knowledge of Medical Plan Design and Claims Processing
Managed Care Representatives must build and maintain productive working relationships with various internal and external customers to solve problems systematically using sound business judgment.
Preferred : EPIC Tapestry Experience
Other
Required : Excellent communication and listening skills
Preferred : Fluency in Spanish
Working Environment : Office
About Us
Start your career journey and become a part of a community of renowned Healthcare professionals. Kelsey-Seybold Clinic is Houston’s fastest growing, multispecialty organization with more than 40 premier locations and over 65 specialties.
Our clinics are comprised of more than 600 physicians and as we continue to grow, our focus is providing quality patient care by adding to our team of clinical and non-clinical professionals that work together in a convenient, coordinated, and collaborative manner.
Enjoy the rewards of a successful career while maintaining a work / life balance by joining our team today and changing the way health cares.
Why Kelsey-Seybold Clinic?
- Medical, Vision, and Dental
- Tuition Reimbursement
- Company Matching 401K
- Employee Reward and Recognition Program
- Paid time off for vacation, sick, and holidays
- Employee Assistance Program
- Continuing Medical Education allowance
Last updated : 2024-03-23
Job Summary
Full Time
Ambulatory Healthcare Services
$36k-43k (estimate)
03/25/2024
04/11/2024
kelsey-seybold.com
PASADENA, TX
1,000 - 3,000
1949
MIKE FITZGERALD
$200M - $500M
Ambulatory Healthcare Services
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About Kelsey-Seybold Clinic
Kelsey-Seybold Clinic is Houston's premier multispecialty group practice, founded in 1949 by Dr. Mavis Kelsey. More than 480 physicians and allied health professionals practice at 25 locations in the Greater Houston area. Kelsey-Seybold offers quality medical care in 55 medical specialties. The organization operates the largest freestanding Ambulatory Surgery Center in the state of Texas and offers state-of-the-art Varian TrueBeam and Varian Edge radiation therapy technology at a nationally accredited Cancer Center. An accredited Sleep Center, comprehensive laboratory services, advanced imagin...g and diagnostics, 17 onsite Kelsey pharmacies, MyKelseyOnline (a secure web portal for patients to communicate with their Kelsey-Seybold doctors, get most test results, and schedule appointments), and Telemedicine Services E-visits and Video Visits with Kelsey-Seybold medical personnel are part of its comprehensive offerings. Kelsey-Seybold partners with major insurers to offer value-based commercial health plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with Kelsey-Seybold Clinic, has achieved the coveted 5-out-of-5-star rating from the Centers for Medicare and Medicaid for five consecutive years. Kelsey-Seybold has been recognized by the National Committee for Quality Assurance (NCQA) as the nations first accredited Accountable Care Organization and a Level 3 (highest) Patient-Centered Medical Home. Kelsey-Seybold has many physicians in the Greater Houston area certified for excellence in diabetes and heart and stroke care by the NCQA. In addition to these recognitions, Kelsey-Seybold is home to a nationally accredited Breast Diagnostic Center, and Endoscopy Center.
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The job skills required for Member service representative include Listening, Health Care, etc. Having related job skills and expertise will give you an advantage when applying to be a Member service representative. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Member service representative. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Member service representative positions, which can be used as a reference in future career path planning. As a Member service representative, it can be promoted into senior positions as a Managed Care Coordinator that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Member service representative. You can explore the career advancement for a Member service representative below and select your interested title to get hiring information.
If you are interested in becoming a Member Service Representative, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Member Service Representative for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Member Service Representative job description and responsibilities
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Essential Duties and Responsibilities Greet members, prospective members and guests, providing exceptional customer service.
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The statement of service must provide the branch of service, rate/rank, all dates of service, the expected date of discharge and anticipated character of service (Honorable, General, etc.).
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Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Member Service Representative jobs
An associate member service also manages membership application requests and evaluates eligibility.
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Building member relationships through quality service experiences.
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Customer service representatives must have high EQ, be excellent at communication, and have superb problem solving skills.
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Step 3: View the best colleges and universities for Member Service Representative.
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