Customer Advocate II

Health Care Service Corporation; Albuquerque (NM); On-site; USD 25,000 - 39,000; Full time

Job summary

Health Care Service Corporation in Albuquerque, NM is seeking a customer service specialist to support providers and the Indian Health Service, handling claims and pricing inquiries with professionalism.

The role emphasizes timely responses, accurate data entry, and the ability to analyze situations, coordinate benefits, and work closely with IHS to streamline processes.

Join a mission-driven team that values reliable service and clear communication while navigating complex healthcare benefits.

Qualifications

• High school diploma or GED.
• 1 year of 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.
• Preference in filling vacancies is given to qualified Indian candidates in accordance with the Indian Preference Act of 1934.

Responsibilities

• Assist providers and IHS by researching and responding to claims, pricing, and COB inquiries.
• Resolve inquiries including adjustments and recommending process improvements.
• Serve as a subject matter expert on projects and testing and liaise between providers and IHS.

Skills

Customer service

Data entry

Phone communication

Analytical skills

Verbal & written communication

Decision making

Education

High school diploma or GED

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.

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.
• 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, INJLF)

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.

Compensation

$17.75 - $28.39

Exact compensation may vary based on skills, experience, and location

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.

To learn more about available benefits, please click https://careers.hcsc.com/totalrewards