1 result for Customer Service Representative in Houston, TX

Pearland, TX
onsite
Temporary
13 - 13.41 USD / Hourly
We are looking for a dedicated Member Services Rep to join our client's team in Pearland, Texas, on a contract basis. This position focuses on supporting the Utilization Management department by ensuring accurate and timely processing of authorization requests while maintaining clear communication with providers and members. The role offers an opportunity to contribute to operational efficiency, regulatory compliance, and quality patient care in a health insurance environment. Key Responsibilities:<ul><li>Handle inbound calls from providers, members, and facilities regarding authorization requests, status updates, and coverage questions</li><li>Review and process authorization requests received via phone, fax, and electronic systems</li><li>Create and document authorization cases accurately within utilization management systems or EHR platforms</li><li>Route cases requiring medical necessity review to clinical staff (RNs, LVNs, Medical Directors)</li><li>Communicate authorization determinations to providers and members in compliance with regulatory requirements</li><li>Maintain accurate, timely documentation to support compliance and operational standards</li><li>Collaborate with internal teams to ensure efficient case processing and resolution</li></ul>
2026-03-23T00:00:00Z