**Responsibilities** Managed Care Representatives respond to inquiries from health plan members, providers and various customers while consistently meeting productivity, quality and service standards. Representatives utilize various internal and external software applications to provide Concierge type services related to health plan operations including benefit interpretation for providers, claims resolution, referral inquiries, general plan benefits, Kelsey-Seybold Clinic information, and enrollment eligibility. Managed Care Representatives handle member and provider calls for self-funded, fully insured and Medicare Commercial plans. **Job Title: Managed Care Representative II** **Location: Pearland Administrative Office** **Department:** **Member Provider Service** **Job Type: Full Time** **Salary Range: $42,697 - $52,744 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)** **Qualifications** **Education** Required: High School Diploma Preferred: Associates or Bachelor’s Degree **Experience** Required: 2 years experience in a health care environment or insurance environment. Knowledge of health care and insurance industries and health care delivery systems Knowledge of Texas Department of Insurance and ERISA Regulations Excellent interpersonal skills to interface with physicians. Strong ability to actively listen to customers, probe for clarification, and provide consultative guidance based upon customers inquiries. Ability to use a variety of software applications Analytical skills to evaluate problems and recommend alternative solutions Preferred: Previous experience with a call documentation system Knowledge of Medical Terminology Ability to Work in a Fast Paced Continuously Changing Environment Knowledge of CPT and ICD9 Codes Ability to understand complex oral and written directions and technical information. **License(s)** Required: N/A Preferred: N/A **Special Skills** Required: Strong knowledge of HMOPlan Design and Claims Processing Managed Care Representatives must build and maintain productive working relationships with various internal and external customers to solve problems systematically using sound business judgment. Preferred: EPIC” Tapestry Experience **Other** Required: Excellent communication and listening skills Preferred: Fluency in Spanish **Working Environment:** Office **About Us** Start your career journey and become a part of a community of renowned Healthcare professionals. Kelsey-Seybold Clinic is Houston’s fastest growing, multispecialty organization with more than 40 premier locations and over 65 specialties. Our clinics are comprised of more than 600 physicians and as we continue to grow, our focus is providing quality patient care by adding to our team of clinical and non-clinical professionals that work together in a convenient, coordinated, and collaborative manner. Enjoy the rewards of a successful career while maintaining a work/life balance by joining our team today and changing the way health cares. **Why Kelsey-Seybold Clinic?** + Medical, Vision, and Dental + Tuition Reimbursement + Company Matching 401K + Employee Reward and Recognition Program + Paid time off for vacation, sick, and holidays + Employee Assistance Program + Continuing Medical Education allowance Kelsey-Seybold Clinic strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by organizational policy or by federal, state, or local laws unless such distinction is required by law. Kelsey-Seybold is a VEVRAA Federal Contractor and desires priority referrals of protected veterans.