Customer Service Representative

This is a fully remote position, open to applicants in New Mexico.

📋 Description

• Assist members with questions concerning health insurance coverage, claims, benefits, and provider networks.

• Offer guidance regarding provider networks, referrals, and pre-authorizations.

• Identify and resolve issues related to billing, payments, and coverage.

• Ensure adherence to HIPAA regulations when managing sensitive member information.

• Collaborate with internal teams to address complex member issues.

• Keep precise records of customer interactions and resolutions in CRM systems.

• Achieve performance targets such as response time, resolution rate, and customer satisfaction scores.

• Remain informed about policies, state regulations, and changes in the healthcare industry.

• Provide support through phone, email, and chat.

⛳️ Requirements

• Prior customer service experience, ideally in healthcare or insurance.

• Excellent verbal and written communication skills.

• Ability to make independent decisions and solve problems while remaining calm under pressure.

• Capability to manage high volumes of calls, chats, and emails efficiently.

• Proficient in computer applications, including CRM and customer support platforms.

• Willingness to work flexible shifts, including weekends and holidays.

• Must be 18 years of age or older.

• High school diploma or equivalent required.

• Must reside in the state of New Mexico.

🏝️ Benefits

• Paid training.

• Opportunities for growth and career advancement.

• A culture that celebrates YOU.

• A supportive team that has your back.