HP Call Center Representative I
Location: Fort Worth, TX
Contract Duration: 26 Weeks
Work Schedule: Monday–Friday, 8:00 AM–5:00 PM Central Time
Lunch Break: 1 Hour
Job Summary
The HP Call Center Representative I provides accurate, prompt, and courteous customer service to members and providers in a fast-paced call center environment. This role responds to inquiries, resolves member concerns, maintains accurate records, and collaborates with internal departments to support members’ healthcare needs and access to services.
Key Responsibilities
Member Issue Resolution
Gather relevant information regarding member complaints and grievances and document details accurately in member accounts.
Collaborate with internal departments to resolve complaints and grievances and ensure timely submission of required information to the Compliance Department.
Use effective questioning, active listening, and problem-solving skills to address concerns and de-escalate frustrated callers.
Member Records and Documentation
Update member accounts with accurate primary care provider (PCP) assignments and demographic information.
Document all member interactions accurately in the core system using proper grammar and terminology.
Identify and report recurring provider-related issues or trends to management.
Customer Service and Call Center Performance
Provide professional, courteous, and timely assistance to members and providers.
Maintain a Customer Service Call Notes Accuracy score above 80%, as measured by the Quality Department.
Meet established call center performance metrics while accurately documenting information during calls.
Follow proper telephone etiquette when managing call transfers, holds, callbacks, and disconnected calls.
Member Education and Support
Explain healthcare programs, benefits, eligibility requirements, and available services in clear, easy-to-understand language.
Assist members in accessing appropriate healthcare services and available resources.
Support members with program renewal requirements and related questions.
Provide information regarding value-added, capitated, and non-capitated services, including medical transportation, Early Childhood Intervention (ECI), and Texas Health Steps.
Cultural Sensitivity and Accessibility
Communicate respectfully and demonstrate cultural sensitivity across phone, email, fax, website, and written interactions.
Arrange in-person interpreters for non-English-speaking members attending medical appointments.
Use appropriate accessibility services, including TTY or Texas Relay, to communicate with members who have hearing impairments.
Compliance and Confidentiality
Follow all departmental policies, procedures, and established service standards.
Maintain the confidentiality and security of member information.
Required Qualifications
High School Diploma or equivalent.
At least six (6) months of experience in a call center or medical setting, or three (3) months of experience as a client call center contractor.
Bilingual proficiency in English and Spanish.
Must successfully pass a Spanish language assessment before hire.
Preferred Qualifications
Excellent verbal and written communication skills, including grammar and documentation accuracy.
Familiarity with medical terminology.
Proficiency in Microsoft Outlook, Word, Excel, and Internet Explorer or equivalent web-based applications.
Strong organizational and time-management skills, with the ability to prioritize tasks and meet established deadlines.
Education and Certifications
Required Education: High School Diploma or equivalent.
Required Certifications/Licensure: None.
Preferred Education: None specified.
Preferred Certifications/Licensure: None specified.