Provider & IHS Claims Advocate

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

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.