Customer Service Representative I

Colorado Access•Denver, CO

3d•Hybrid

About The Position

Colorado Access is a Colorado-based, mission-driven organization focused on improving health care quality, member experience, outcomes, and cost for people enrolled in Child Health Plan Plus and Health First Colorado. The Customer Service Representative I supports this mission by providing professional, courteous, and accurate service to members and customers. The role handles incoming and outbound calls, email inquiries when assigned, policy and account questions, and requests related to benefits, coverage, claims, and other general inquiries. The position uses company resources and multiple systems to research, resolve, and document issues, while adhering to HIPAA requirements and department standards. This is a hybrid role combining in-office and remote work. Colorado Access is unable to support employees who live outside Colorado. The position is non-exempt and hourly, with annual compensation listed as $51,600 to $53,500.

Requirements

High school diploma or equivalent.
At least 2 years of customer service experience.
Ability to work in a call center environment and respond to inquiries professionally.
Excellent written and verbal communication skills.
Proficiency with Microsoft Office applications, including Word, Excel, PowerPoint, Outlook, and SharePoint.
Ability to work with a variety of project management tools.
Ability to manage multiple priorities and projects with tight deadlines when required.
Support for the company's mission, vision, and values.

Nice To Haves

Bilingual in Spanish and English.
Experience in medical insurance and Medicare and Medicaid eligibility and enrollment.

Responsibilities

Answer incoming calls professionally and courteously, using a customer-focused approach.
Remain available throughout scheduled shifts to provide timely service.
Research, resolve, and accurately document customer inquiries, concerns, and issues.
Provide clear information and education about benefits, coverage, policies, claims, and general inquiries.
Use policies, procedures, training materials, handouts, databases, and multiple systems to complete daily work.
Document interactions clearly and thoroughly in the E-Plus system or other required systems.
Make outbound follow-up calls regarding benefits information, claims clarification, and other customer needs as assigned.
Respond to Customer Service inbox emails professionally and clearly, while maintaining HIPAA compliance, when assigned.
Assist members with basic policy updates, including contact information changes, and answer general account questions.
Provide general guidance on filing claims and required documentation.
Follow assigned daily schedules for breaks and lunches.
Maintain regular attendance and punctuality.
Meet or exceed performance, quality, and customer service standards set by department leadership.
Identify and appropriately handle grievances and appeals, facilitating quality outcomes or resolutions for applicable parties.

Benefits

Paid time off and floating holidays.
Nine company-paid holidays.
Hybrid work environment.
Employee Assistance Program.
401(k) retirement plan.
Tuition reimbursement, based on eligibility.
Leadership training, promotion opportunities, performance evaluations, and employee recognition.
Language pay stipend.
Medical, dental, and vision insurance beginning the first day of the month following the start date.
Supplemental insurance, including critical illness and accidental injury coverage.
Health care and dependent care flexible spending account options.
Employer-paid basic life insurance and AD&D coverage for the employee, spouse, and dependents.
Short-term and long-term disability coverage.
Voluntary life insurance for the employee, spouse, and dependents.
Annual bonus program, based on eligibility, requirements, and performance.