Customer Advocate II

Health Care Service Corporation•Albuquerque, NM

7d•$18 - $28•Remote

About The Position

This position is responsible for providing assistance to providers and Indian Health Services (IHS). This position researches, analyzes, and responds to telephone and written inquiries related to claims issues, pricing issues, and coordination of benefits. This position is also responsible for resolution of inquiries, including adjustments and making recommendations regarding process improvements. This position is a subject matter expert regarding projects and testing. This position also works closely with the IHS customer and acts as a liaison between the provider and IHS.

Requirements

High school diploma OR GED.
1 year customer service experience in a health care or health insurance environment.
Experience evaluating customer situations, making decisions, and responding quickly to questions.
Data entry and/or typing experience.
Interpersonal, verbal and written communication skills and independent decision making skills.
Analytical and organizational skills.
Ability to spend approximately 90% of the scheduled time on the phone according to business needs and sit for long periods of time with scheduled breaks.

Nice To Haves

1 ½ years customer service experience.
6 months data entry experience in an office environment.
Experience working with various lines of business, i.e. CDHP, Medicare, Wellness, and Disease Management.
Knowledge of medical terminology and anatomy.
Referral preference given to applicants able to take and meet testing criteria.
Preference in filling vacancies is given to qualified Indian candidates in accordance with the Indian Preference Act of 1934 (title 25, USC Section 472) Native American Indian Preference shall apply to this position pursuant to the Indian Self-Determination and Education Assistance Act (24 U.S.C. 450, et seq.), 25 CFR 271.44 and other relevant laws (title 25,

Responsibilities

Provide assistance to providers and Indian Health Services (IHS).
Research, analyze, and respond to telephone and written inquiries related to claims issues, pricing issues, and coordination of benefits.
Resolve inquiries, including adjustments and making recommendations regarding process improvements.
Act as a subject matter expert regarding projects and testing.
Work closely with the IHS customer and act as a liaison between the provider and IHS.