RESPONSIBILITIES
Has comprehensive knowledge of STAR Kids and STAR+PLUS programs in order to serve as a liaison to members and providers regarding benefits and services, resolving member and provider issues, providing information regarding all aspects of the Special Health Care Needs (SHCN) call center which includes STAR Kids and STAR+PLUS program either by phone or in person. Ensures compliance with the Health Insurance Portability and Accountability Act (HIPAA) related policies such as Abuse, Neglect and Exploitation (ANE), Fraud, Waste, and Abuse (FWA) in regards to all aspects of operations within Member Services. Staff designated at primary to STAR Kids hotline must answer 95% of STAR Kids calls. Maximum call duration limits are not imposed. Calls are of sufficient length to ensure adequate information is provided to caller.
EDUCATION/EXPERIENCE
Minimum two years college level work in business, health care administration or related courses is required or four year experience as a customer service representative. Minimum of two year of HMO experience is required. Health care problem resolution and experience with special healthcare members is preferred.
University Health is the only locally owned health system in San Antonio. For more than 100 years, University Health has been here to heal, improve health, train the next generation of medical professionals and ensure the people of San Antonio, Bexar County and South Texas have access to primary and advanced specialty care close to home.
Almost 11,000 employees and more than 1,200 physicians provide specialized services, including the region’s only Level I trauma center for both adults and children, and maternal and neonatal intensive care centers designated at the highest levels by the State of Texas.
As the region’s only academic health system, University Health is a hub of innovation and discovery, committed to delivering patient-centered, culturally competent, high-quality and compassionate care, based on a strong foundation of outcomes‐based research and innovative teaching.
Learn more at UniversityHealth.com. Follow us on Facebook, Instagram and X.
