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HP Customer Serv Rep Non Bil

Location
Corpus Christi, TX
Work mode
On-site
Employment type
Full-time

About the job

Where compassion meets innovation and technology and our employees are family.

Thank you for your interest in joining our team! Please review the job information below.

$3,500 Sign-on Bonus Offered! GENERAL PURPOSE OF JOB: The Customer Service Representative is responsible for the assisting Member/ Provider with healthcare inquires concerns, or complaints via telephone.

ESSENTIAL DUTIES AND RESPONSIBILITIES: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or health plan administration, as required.

General Duties:

Assist members and providers by responding to telephone inquiries in a prompt, accurate and objective manner regarding but not limited to:

o Abuse, Neglect and Exploitation o Authorizations o Behavioral Health o Claims o Complaints o Crisis Calls o Eligibility o Health Insurance Benefits o Locating providers o Pharmacy Benefits o Transportation o Waste Abuse and Fraud

• 90% of the scheduled time on the phone according to business needs.

  • 90% of the scheduled time on the phone according to business needs.
  • Drives resolution of caller questions/issues on the first call whenever possible and ensures proper documentation of calls and resolution actions.
  • Understand and adhere to HIPAA requirements.
  • Adhere to Regulatory Guidelines and policies & procedures.
  • Navigating through complex computer systems to identify the status of the issue and provide appropriate response to caller.
  • Review previous call interactions/notes.
  • Communicate monthly messages to members and providers on a specific need basis.
  • Deal tactfully and empathetically with members and providers.
  • Establish and maintain effective working relationships with provider office staff.
  • Read, comprehend, and verbalize processes and procedures of the organization and of health insurance coverage.
  • Multi-task by utilizing multiple complex computer applications.
  • Pay close attention to detail.
  • Identify issues/trends and escalate to Supervisor / Manager when assistance is needed.
  • Develop relationships with other departments to provide feedback about root cause issues.
  • Intervene with providers on behalf of the customer to assist with appointment scheduling or connections with specialists for assistance when needed.
  • Assist customers in navigating through the Driscoll Health Plan website and encourage and reassure them to become self-sufficient.
  • Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member and or provider.
  • Research complex issues across multiple databases and work with internal departments to resolve customer issues and/or partner with others to resolve escalated issues.
  • Other duties as assigned.
  • Minimum of a high school diploma or equivalent
  • Customer service experience
  • Experience working in a call center or healthcare related field is a plus
  • Strong customer service skills, including courteous telephone etiquette and professionalism
  • Prior understanding and awareness of call center metrics and goals preferred
  • Prior healthcare experience, in particular, Medicaid Insurance Plans preferred
  • Ability to type a minimum of 35 words per minute
  • Knowledge of managed care processes and health insurance coverage preferred
  • Knowledge of medical terminology preferred
  • Outstanding communication skills and the ability to understand complex situations to effectively handle escalated customer needs
  • Analytical skills and the ability to read and interpret data
  • Problem solving abilities
  • Ability to work independently and as a part of a team
  • Ability to operate computer programs – Proficiency with Microsoft Office applications, particularly Outlook, Word, and MS Teams

From 15 Driscoll Children's Hospital-Rio Grande Valley's careers page (Workday), checked 31 Oct 2026.

How to apply

  1. Select Apply on driscoll.wd1.myworkdayjobs.com. It opens 15 Driscoll Children's Hospital-Rio Grande Valley's own application form in a new tab, run on Workday.
  2. Fill in the form and upload your résumé there. Jobiwork never sees your application.
  3. 15 Driscoll Children's Hospital-Rio Grande Valley will reply to you directly. No real employer asks you for money to apply.

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