Customer Service Representative I

Colorado Access•Denver, CO
•Hybrid

About The Position

We are looking for a CUSTOMER SERVICE REPRESENTATIVE I who can help shape our vision and support our mission. Bilingual in Spanish/English is highly preferred. This position will be a hybrid model work environment, a blend of ‘In-Office’ and ‘Remote.’ We serve the underserved and most vulnerable populations in our community through access to quality and affordable health care. No matter what you do for Colorado Access, you are impacting our community and making a difference.

Requirements

  • High school diploma or equivalent required.
  • Minimum of 2 years’ customer service experience is required.
  • Ability to work within a call center environment and answer inquiries in a professional manner.
  • Requires the ability to identify and appropriately handle grievances and appeals, and to facilitate quality outcomes and/or resolutions for the benefit of all applicable parties.
  • Demonstrates support for the company’s mission, vision and values.
  • Excellent written and verbal communication skills.
  • Proficient in Microsoft office applications (Word, Excel, PowerPoint, Outlook, SharePoint) with ability to work with a variety of project management tools.
  • May be required to manage multiple priorities and projects with tight deadlines.
  • A valid driver's license and proof of current auto insurance will be required for any position requiring driving.

Nice To Haves

  • Bilingual in Spanish/English is highly preferred.
  • Experience in medical insurance and Medicare and Medicaid eligibility and enrollment is highly preferred.

Responsibilities

  • Answer incoming calls with a customer-focused approach while maintaining professionalism and courtesy at all times.
  • Maintain full availability during scheduled shifts, remaining accessible throughout the workday to ensure timely service.
  • Research, resolve, and document customer inquiries, concerns, and issues accurately and efficiently.
  • Provide clear and accurate information and education related to benefits, coverage, policies, claims, and general inquiries.
  • Utilize available resources such as policies, procedures, training materials, handouts, databases, and multiple systems to complete daily work.
  • Document all interactions clearly and thoroughly in the E-Plus system or other required systems.
  • Conduct outbound calls for follow-ups, benefits information, claims clarification, and other customer-related needs as assigned.
  • Respond to email inquiries sent to the Customer Service inbox in a professional, clear, and HIPAA-compliant manner when assigned.
  • Assist members with basic policy updates such as contact information changes and general account questions.
  • Provide general guidance on how to file claims and what documentation is required.
  • Follow a daily schedule for breaks and lunches as assigned.
  • Maintain regular attendance and punctuality as an essential function of the role.
  • Consistently meet or exceed performance, quality, and customer service standards set by department leadership.

Benefits

  • PTO
  • Floating holidays
  • Nine company paid holidays
  • Employee Assistance Program
  • 401K
  • Tuition reimbursement
  • Leadership training
  • Promotion opportunities
  • Performance evaluations
  • Employee recognition
  • Language pay stipend
  • Medical, dental, vision insurance that starts the first day of the month following start date.
  • Supplemental insurance such as critical illness and accidental injury.
  • Health care and dependent care flexible spending account options.
  • Employer-paid basic life insurance and AD&D (employee, spouse and dependent).
  • Short-term and long-term disability coverage.
  • Voluntary life insurance (employee, spouse, dependent).
  • Annual bonus program
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