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Member Services Representative

Houston, Texas

$19.69/hour

Office & Professional

Job ID: 58906710

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Job Description

HIRING IMMEDIATELY: MEMBER SERVICES REPRESENTATIVE IN HOUSTON, TX 77081
Accurate Personnel is hiring immediately for a Member Services Representative to join our team in Houston, TX. This individual will resolve Physician and /or Provider focused issues (educational needs, contract verification, participation status, claims payment discrepancies, interaction) with the clients provider portal. The ideal candidate will have working knowledge of the designated QNXT referral, claims, eligibility, and provider modules, as well as all CACTUS modules and serve as the primary party responsible for responding to QNXT call tracking issues referred to Network Management. Apply today and kick-start your career today!
Pay, Schedule, and Location
  • Ranging to $19.69/hour
  • Full Time Schedule
  • Excellent benefits package, including medical, dental, and vision
  • Located in Houston, TX 77081
Duties and Responsibilities
  • Resolves Physician/Provider focused issues as received from internal parties, on an independent basis versus relying on a third party, except when claim adjustments are warranted
  • Effectively follows-up with Physicians/Providers as it relates to questions forwarded by network management or other internal staff, comprehensively documents transactions in compliance with the clients policy
  • Investigating and resolving Member complaints against Physicians/Providers, as received by Member Services Department or Compliance, including but not limited to; appointment wait times and violations of TX Provider Marketing Guidelines
  • Serves as the primary party responsible for responding to QNXT call
  • Tracking issues referred to network management
  • Ensures new Physicians/Providers receive, and reviews with new Physicians/Providers required initial educational materials, i.e., provider manual, quick reference guide, etc.
  • Provides ongoing individual telephonic support & education of Physicians/Providers on relevant topics, including but not limited to, identified claims and/or authorization issues, new initiatives, availability, and functionality of the clients portal, etc
  • Remain knowledgeable of components in the clients engagement platform
  • Collaborating with leadership, co-workers, and staff in other departments
  • Demonstration of good communication and interpersonal skills
Requirements and Qualifications
  • High School or GED required
  • Bachelors of Arts/Bachelors of Science, in Business preferred 
  • 2 years experience in Managed Care (Provider Relations/Services Contracting; preferably in Claims Adjudication, Medical Coding)
  • Microsoft Office (Word, Excel, and Outlook)
  • Office setting with low partitions and open floor plan
  • Customer service skills such as reliability, integrity, teamwork, and change management, plus strategic vision and team development for supervisory roles
  • Exceptional verbal and written communication skills 
  • Problem analysis and strong attention to detail
  • Able to lift up to 20lbs occasionally
  • Work in a high-rise building
  • Close paper/computer work
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(Salary range based on experience)
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ABOUT ACCURATE PERSONNEL
Do you need your next job fast? Accurate Personnel is here to help! As an industry-leading full-service staffing agency, we have all the tools you need to start earning that next paycheck soon. Send us your application and our team will instantly get to work on finding you the right placement to fit your needs. Accurate Personnel has provided temporary job services and direct hire searches for 45 years. Our expertise has allowed us to grow from a regional Chicagoland office into a nationwide search firm that services over 500 clients while never losing sight of personalized service. Let Accurate work for you. Apply with us today!
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Accurate Personnel provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
(HTB)

Job ID: 58906710

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What People Say About Accurate

“My dad and I had to drive about 40 minutes out to get here, and it was beyond worth it. We’ve tried agencies closer to home, with completely different level of service and attention. All staff here is incredibly friendly and patient, especially Juana who’s been helping us directly for about a week. She made things happen and with the kindest attitude. We greatly appreciate this place and recommend it, even if it’s a bit further away from you!”

Vanessa M.

“Applied for a higher level operations role being sourced for one of Accurates clients, worked with Martin throughout the process and he has been communicative, engaging and quickly understood my fit for the targeted role. He was able to assess my background and his knowledge of the clients needs to provide great feedback and move both sides through the evaluation process. I highly recommend working with Martin.”

Andrew N.

“I had a great experience here. This is the first time I received fair treatment at a Temp office. Usually it’s always people being rude and giving you the run around but I’m glad I got to be helped by Montserrat. She helped me through the process and set expectations with me on the type of work and times I was also looking for despite how busy they were that day. The couple of times I have walked in there she also has greeted me and answered any questions. Some of the other staff also seem friendly. I highly recommend this location and from my experience here to ask for her to help you because I personally had a great experience along with 2 other friends I recommended.”

Paty C.

“I am pleased to say that I have had a very nice experience with the treatment of the staff. Above all, the attention of Maria A García always guides you in everything and almost always places you in a company that helps in everything within her reach.”

Anais L.

“Thanks to Maria and Accurate for the next day after I asked for help, they found me a job. And not only that but you were always looking for better options until now that I am in an excellent job. Anyone I know always recommends you, without a doubt the best at their job, thank you.”

Deykembert A.

“All I have to say is that Accurate personnel has given me the opportunity to become successful with all the necessary tools to become efficient, in my job position as an onsite supervisor, our coach and Mentor Raquel Acevedo does a well job! Building strong efficient associates to provide the best and professional customer service, I'm proud to be part of that team. The Accurate team.. from the East to the West Accurate is the best.”

Carlos R.