Customer Service Advocate III - Community Health Choice
Harris Health System
Location: Houston, Texas
Type: Full Time
Internal Number: 160913
JOB SUMMARY: The Customer Service Advocate III is a position within the Community Health Choice Provider Call Center. The Customer Service Advocate III is primarily responsible for, but not limited to responding to incoming provider hotline inquiries as they relate to benefit and eligibility verification, claim status (with the ability to identify if a claim requires reconsideration), authorization status, and complaints, accurate documentation recording of all provider calls; effective follow-up of provider calls, as required; and proper electronic routing with effective documentation skills.
MINIMUM QUALIFICATIONS: Education/Specialized Training/Licensure: High School Diploma or GED. Work Experience (Years and Area): Three (3) years Managed Care experience to include Call Center, with claims knowledge. Cross-functionality in Claims, Benefits and Eligibility for all lines of business. Software Operated: Microsoft Office (Word, Excel, Outlook)
SPECIAL REQUIREMENTS: Communication Skills: Above Average Verbal (Heavy Public Contact) Writing /Composing: Correspondence / Reports
Other Skills: Analytical, Mathematics, Medical Terms, Research
Other Requirements: Ability to work independently under minimal direction. Moderate to advanced computer knowledge required.
The Harris Health System is a fully integrated healthcare system that cares for all residents of Harris County, Texas. We are the first accredited healthcare institution in Harris County to be designated by the National Committee for Quality Assurance as a Patient-Centered Medical Home, and are one of the largest systems in the country to achieve the quality standard. Our system includes 23 community health centers, five school-based clinics, a dental center and dialysis center, mobile health units, a rehabilitation and specialty hospital and two full-service hospitals.Ben Taub Hospital is a world renowned Level I Trauma Center with 586 licensed acute-care beds and provides a wide range of specialty care outpatient services. Lyndon B. Johnson Hospital is a 328 licensed bed acute-care hospital with a newly expanded Level III trauma center and a distinguished regional center for neonatal intensive care for high-risk deliveries.Harris Health is a teaching system for Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth). We train the next generation of healthcare providers on the latest medical procedures and technological breakthroughs.With... our fully integrated electronic medical records system, we offer patients the convenience and assurance that their medical history is accurate, safe and available when and where it is needed. Our Medical Home designation ensures that we offer a full range of preventive, specialty and acute care services for the entire family.