Community Health Choice

Houston, TX, USA

Full time

Healthcare / Insurance

Feb 24

This job is no longer accepting applications.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Skills / Requirements

JOB SUMMARY: The Customer Service Advocate II is a position within the Community Health Choice Customer Service Center that is primarily responsible for, but not limited to responding to incoming hotline inquiries as they relate to benefits and eligibility verification, claim status (with the ability to identify if a claim requires reconsideration), authorization status, and complaints, accurate documentation recording of all calls; effective follow-up of calls, as required; and proper electronic routing with effective documentation skills while maintaining confidentiality per HIPAA guidelines.


1. Education/Specialized Training/Licensure: High School diploma or GED.

2. Work Experience (Years and Area): 6 months of Managed Care or health care insurance experience to include Call Center, with claims knowledge. Cross-functionality in Claims, Benefits and Eligibility for at least two (2) lines of business.

3. Management Experience (Years and Area): N/A

4. Software Operated: Microsoft Office (Word, Excel, Outlook)

SPECIAL REQUIREMENTS: (Check Applicable Areas)

1. Communication Skills:

Above Average Verbal (Heavy Public Contact) ¿

Languages: Spanish or threshold language preferred

Writing /Composing: Correspondence / Reports

2. Other Skills: Analytical, Mathematics, Medical Terminology, Research, MS Word , MS Excel

3. Work Schedule: Flexible, Overtime

4. Other Requirements:

Ability to work independently under minimal direction. Moderate to advanced computer knowledge required.

RESPONSIBLE TO: Supervisor/Manager


Application Instructions

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Community Health Choice

Community Health Choice is a local, non-profit health plan that offers affordable coverage to Texans.