REMOTE Medical Customer Service Representative

Remote, USA Full-time Posted 2025-03-08

? Must live in Waco, TX or surrounding areas*

Description...

Act as an advocate for the Member and a liaison between the Health Plan and Providers to ensure availability and access to care. Establish a community presence promote Member education identify and resolve any systemic barriers that limit Members access to appropriate care.

  • Receive and respond to Member complaints and formal grievances and identify potential access barriers and resolve as indicated in the grievance procedure.
  • Investigate and resolve access and cultural sensitivity issues identified by Member Services staff State staff providers advocacy organizations and recipients.
  • Participate in local community organizations to acquire knowledge and insight regarding the special health care needs of Members and update and revise educational materials as appropriate.
  • Serve as primary contact for Member advocacy groups human services agencies and the State entities.
  • Maintain confidentiality per HIPAA guidelines.

Additional Skills & Qualifications:

+ High school diploma or equivalent.

+ 3 years of customer service experience in a healthcare environment.

+ Medicare and/or Medicaid experience preferred.

+ Bilingual in Spanish preferred.

Experience Level:

Expert Level

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law

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