Remote Medical Customer Service Representative - Healthcare Advocacy & Support Specialist (Waco, TX or Surrounding Areas)

Join Our Collaborative Team as a Remote Medical Customer Service Representative

Are you a compassionate and results-driven professional looking for a challenging yet rewarding role in a dynamic healthcare environment? Do you have a passion for delivering exceptional customer service and advocating for members' needs? We're seeking a skilled and dedicated Remote Medical Customer Service Representative to join our team as a Healthcare Advocacy & Support Specialist. As a fully remote opportunity, this position offers a modern work style with a competitive salary and the chance to make a meaningful difference in the lives of our members.

About Our Company and Industry

At TEKsystems, we're partners in transformation, helping clients activate ideas and solutions to take advantage of a new world of opportunity. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. Our company is part of the Allegis Group, a global talent management firm that connects people and organizations to achieve their goals. We're committed to fostering a culture of innovation, collaboration, and inclusivity, and we're looking for talented individuals like you to join our team.

Job Summary

As a Remote Medical Customer Service Representative, you will serve as a vital liaison between our health plan and providers, ensuring that our members have access to quality care and support. You will be responsible for advocating for members' needs, resolving complaints and grievances, and identifying potential access barriers. This role requires a strong and diverse skillset, including excellent communication and problem-solving skills, as well as a deep understanding of the healthcare industry.

Key Responsibilities

• Act as an advocate for members and a liaison between the health plan and providers to ensure availability and access to care.
• Establish a community presence, promote member education, and identify and resolve systemic barriers that limit members' access to appropriate care.
• Receive and respond to member complaints and formal grievances, identifying potential access barriers and resolving them according to our 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 healthcare needs of members and update and revise educational materials as needed.
• Serve as a primary contact for member advocacy groups, human services agencies, and state entities.
• Maintain confidentiality per HIPAA guidelines.

Essential and Preferred Qualifications

To succeed in this role, you will need:

• A high school diploma or equivalent.
• At least 3 years of customer service experience in a healthcare environment.
• Excellent communication and problem-solving skills.
• Ability to work independently in a remote setting.
• Strong analytical and critical thinking skills.

Preferred qualifications include:

• Medicare and/or Medicaid experience.
• Bilingual in Spanish.

Skills and Competencies Required for Success

To excel in this role, you will need to possess:

• Strong communication and interpersonal skills.
• Excellent problem-solving and analytical skills.
• Ability to work in a fast-paced environment and prioritize multiple tasks.
• Strong customer service skills and a passion for delivering exceptional service.
• Knowledge of healthcare industry trends and regulations.
• Ability to maintain confidentiality and handle sensitive information.

Career Growth Opportunities and Learning Benefits

At TEKsystems, we're committed to helping our employees grow and develop their skills. As a Remote Medical Customer Service Representative, you will have access to:

• Ongoing training and professional development opportunities.
• Career advancement opportunities within the company.
• A collaborative and supportive work environment.

Work Environment and Company Culture

As a fully remote employee, you will enjoy a modern and flexible work style that allows you to work from the comfort of your own home. Our company culture is built on a foundation of innovation, collaboration, and inclusivity, and we're committed to fostering a work environment that is supportive and engaging.

Compensation, Perks, and Benefits

We offer a competitive salary and benefits package that includes:

• A reliable and steady income.
• Opportunities for career advancement and professional growth.
• A comprehensive benefits package.
• A flexible and modern work environment.

Are You the One We're Looking For?

If you're a motivated and compassionate professional with a passion for delivering exceptional customer service and advocating for members' needs, we want to hear from you. As an equal opportunity employer, we're committed to considering all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information, or any characteristic protected by law. If you believe you have what it takes to succeed in this role, please submit your application today.

We're excited to welcome a talented and dedicated Remote Medical Customer Service Representative to our team and look forward to hearing from you soon.