Member Service Representative
Pride Health, Houston, TX, United States
Job Title: Member Services Representative – Call Center (Bilingual)
Location: Houston, TX 77086
Shift: 8-hour shift between 7:00 AM – 6:00 PM (Monday–Friday)
Duration: 3 months with a strong possibility of extension
Pay Range: $15 – $18/hr
Key Responsibilities
Handle inbound calls from members/providers regarding eligibility, benefits, claims, and referrals
Research and resolve issues while coordinating with internal teams
Assist with appointment scheduling and care navigation
Document interactions in systems (EPIC, MACESS, etc.)
Ensure HIPAA compliance and maintain confidentiality
Provide empathetic, high-quality customer service in a fast-paced environment
Required Qualifications
Minimum 1–2 years of call center experience
Medicaid or managed care experience required
Ability to explain medical benefits and coverage
Familiarity with call center metrics (AHT, QA, adherence, FCR)
Strong communication, multitasking, and problem‑solving skills
Screening Requirements Candidates must be able to answer:
Call center experience and environment
Familiarity with benefits, eligibility, and claims
Call center metrics handled
Comfort handling high call volumes and escalations
“Pride Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors”
#J-18808-Ljbffr
Location: Houston, TX 77086
Shift: 8-hour shift between 7:00 AM – 6:00 PM (Monday–Friday)
Duration: 3 months with a strong possibility of extension
Pay Range: $15 – $18/hr
Key Responsibilities
Handle inbound calls from members/providers regarding eligibility, benefits, claims, and referrals
Research and resolve issues while coordinating with internal teams
Assist with appointment scheduling and care navigation
Document interactions in systems (EPIC, MACESS, etc.)
Ensure HIPAA compliance and maintain confidentiality
Provide empathetic, high-quality customer service in a fast-paced environment
Required Qualifications
Minimum 1–2 years of call center experience
Medicaid or managed care experience required
Ability to explain medical benefits and coverage
Familiarity with call center metrics (AHT, QA, adherence, FCR)
Strong communication, multitasking, and problem‑solving skills
Screening Requirements Candidates must be able to answer:
Call center experience and environment
Familiarity with benefits, eligibility, and claims
Call center metrics handled
Comfort handling high call volumes and escalations
“Pride Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors”
#J-18808-Ljbffr