Call Center Rep. II, (El Paso Health)

Position Overview

Supports member and provider complex questions and concerns related to detailed claim, membership, authorization, benefits, contracts, and a variety of other call center related core activities. Participates in member wellness activities, re-enrollment/dis-enrollment activities, and conducts surveys and assessments. Assists with carrying out all call center activities and supports other departments within El Paso Health (EPH) as necessary. Focuses on a primary line of business which may include, but is not limited to, Medicare, Medicaid, CHIP, Health Care Options (HCO), and Third Party Administration (TPA) programs.

Key Responsibilities

• Supports member and provider inquiries regarding claims, membership, authorization, benefits, and contracts.
• Participates in member wellness and re-enrollment/dis-enrollment activities.
• Conducts surveys and assessments.
• Assists with overall call center operations and provides support to other departments.
• Focuses on key programs including Medicare, Medicaid, CHIP, HCO, and TPA.

Required Qualifications

• Qualifications: Excellent bi-lingual oral/written skills in English and Spanish; excellent interpersonal skills; strong knowledge of Microsoft Office programs; computer awareness with data entry proficiency; arithmetic competence; and attention to detail.
• Experience Required: Two years of experience in a call center environment with hands-on use of a management information system to track member and provider interactions, including familiarity with Medicare, Medicaid, CHIP, or Third Party Administration systems.
• Education: High school diploma or GED equivalent.