Member and Providers Service Rep I Job

Children's Health - General Careers

Job Number: 54527

Location: Dallas, TX

Date Posted: 6-8-2018



This position is a call center customer service position. The Member and provider services representatives will receive incoming calls from members and providers with questions about Children's Medical Center Health Plan benefits or processes. The representatives will also be conducting outbound calls either for welcome call surveys or follow up.


  • Provide excellent customer service to a variety of customers via telephonic contact.
  • Complete outbound assessments or follow up calls.
  • Adhere to their assigned schedules in order to provide support for the inbound calls.


  • Call Center or Customer Service, required.
  • Experience with medical claims, preferred.
  • Managed care or health care experience, preferred.


  • High school diploma or equivalent required; additional training beyond high school, required.
  • Two-year Associate's degree or equivalent experience, preferred.
  • Four-year Bachelor's degree or equivalent experience, preferred.


  • Valid Driver's License, required.


  • Maintain effectiveness when experiencing major changes in work responsibilities or environment; adjust effectively to work within new work structures, processes, requirements, or cultures.
  • Use appropriate interpersonal styles to establish effective relationships with customers and internal partners; interact with others in a way that promotes openness and trust and gives them confidence in one's intentions.
  • Ensure that the customer perspective is a driving force behind business decisions and activities; craft and implement service practices that meet customers' and own organization's needs.
  • Develop and use collaborative relationships to facilitate the accomplishment of work goals.
  • Identify and understand issues, problems, and opportunities; compare data from different sources to draw conclusions; use effective approaches for choosing a course of action or developing appropriate solutions; take action that is consistent with available facts, constraints, and probable consequences.
  • Take prompt action to accomplish objectives; take action to achieve goals beyond what is required; be proactive.
  • Deal effectively with others in an antagonistic situation; use appropriate interpersonal styles and methods to reduce tension or conflict between two or more people.
  • Effectively manage one's time and resources to ensure that work is completed efficiently.
  • Accomplish tasks by considering all areas involved, no matter how small; showing concern for all aspects of the job; accurately checking processes and tasks; being watchful over a period.
  • Set high standards of performance for self and others; assume responsibility and accountability for successfully completing assignments or tasks; self-impose standards of excellence rather than having standards imposed.
  • Assimilate and apply new job-related information in a timely manner.
  • Clearly convey information and ideas through a variety of media to individuals or groups in a manner that engages the audience and helps them understand and retain the message.


Sedentary - Exerting up to 10lbs. occasionally or negligible weights frequently; sitting most of the time.

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