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Member Services Remote Call Center

Broad Path Healthcare Solutions Richardson, TX

Job Description:

Full-Time Seasonal Member Service Representatives will receive inbound calls from current and potential members with inquiries which may include benefit and eligibility information, claims and billing, primary care physician assignments, etc. Representatives may also receive calls from providers with questions regarding member eligibility, coverages, benefit types, copays, claims, etc. Representatives will be expected to maintain performance and quality standards based on established call center metrics and benchmarks.

Successful candidates are available to work the entire season for the project and be available to work during the hours of 7:00 AM – 10:00 PM Central Standard Time. (40 hours/week).

General Duties:

  • Receive and respond to telephone inquiries from members regarding eligibility, benefits and authorization of services
  • Responsible for verifying member coverages, benefit types, eligibility dates, and claim payment/statuses for providers
  • Estimate member’s out of pocket expenses for select procedures or services and explain member copayments
  • May be required to make outbound calls to assist members in coordinating care
  • Document all call information per approved operating procedures
  • Use tools and problem-solving skills to identify caller needs, including potential crisis calls, and route calls to appropriate resource per standard operating procedures
  • Identify and employ alternative approaches to communicate with callers when encountering barriers and escalate as needed

Required Qualifications:

  • Position requires 100% Attendance During Paid Training Period
  • Must be able to work the duration of the project (October – March)
  • Must be able to work from home in either a study or second bedroom with a door, desk, and access to your ethernet cord in your modem or wireless router (we supply all the equitment to perfom the job)
  • Must be able to work during the hours of operation 7:00 AM – 10:00 PM CST (40 hours/week)
  • 1-year Commercial (under 65), Medicaid, and/or Medicare health plan experience OR the equivalent customer service/call center experience. The experience must be no older than 2014-2015 with at least a portion of that experience occurring no later 2015.
  • Position requires strong computer literacy (Microsoft Windows, keyboarding skills, strong systems aptitude, etc.)
  • Position requires strong computer & telephone multitasking skills including: the ability to effectively search for and type information on the computer, navigate through multiple windows and screens quickly, and inputting information accurately while keeping pace with the call.
  • Excellent verbal and written communication skills
  • Ability to remain focused and productive each day though tasks may be repetitive
  • Reliable internet with 5 Mbps download and 2 Mbps upload speed (we provide you with the equipment)

Preferred Qualifications:

Previous successful work at home experience

Broad Path Healthcare Solutions


Richardson, TX