Customer Advocate II

Health Care Service Corp.; Albuquerque (NM); On-site; USD 23,000 - 39,000; Full time

Job summary

Health Care Service Corporation (HCSC) seeks a dedicated claims support specialist to assist providers and IHS by addressing inquiries on claims, pricing, and coordination of benefits. The role emphasizes strong phone engagement and timely problem resolution.

The position requires a high school diploma or GED and at least 1 year of customer service experience in health care or health insurance, with solid data entry and communication skills.

Qualifications

• High school diploma or GED.
• 1 year of customer service in a health care or health insurance environment.
• Ability to evaluate customer situations, make decisions, and respond quickly to questions.
• Data entry and 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.

Responsibilities

• Assist providers and IHS, researching, analyzing, and responding to telephone and written inquiries related to claims issues, pricing issues, and coordination of benefits.
• Resolve inquiries, including adjustments and making recommendations for process improvements.
• Serve as a subject matter expert on projects and testing, collaborating with the IHS customer and acting as a liaison between the provider and IHS.

Skills

Customer service

Data entry

Communication

Analytical thinking

Organization

Phone skills

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary 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.

Job 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.

Preferred Job Requirements

• 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 United States Code Section 472) Native American Indian Preference shall apply to this position pursuant to the Indian Self-Determination and Education Assistance Act (24 United States Code 450, etc.), 25 CFR 271.44 and other relevant laws.

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Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range $17.75 - $28.39 Exact compensation may vary based on skills, experience, and location.

For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment.

HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations. Please note that only requests for accommodations in the application process will be returned.