Customer Service Representative I

Customer Service Representative I

This is a hybrid position, both in-office and remote.

Location : Albuquerque, NM

Primary Job Responsibilities :

To provide polite, accurate and professional customer service related to eligibility, dental benefits, and claim payment; performs claim and benefit research, reconciliation, adjudication, data entry, adjustments, and related reporting. Respond to written inquiries in a timely and professional manner.

Reporting : Manager, Operations

Primary Job Responsibilities :

• Role model and live the company values and behaviors. Know the company vision, mission, and objectives and continually communicate and reinforce these to fellow Team Members.
• Responds to member inquiries via telephone, e-mail, or chat.
• Open, sort, and scan incoming claim and non-claim related mail.
• Completes timely and accurate entry of claims related data including the auditing, coding, and entry of claims.
• Maintains the required performance standards relating specifically to Customer Services and claims accuracy.
• Maintains files and databases as required by department policies and procedures.
• Coordinates inquiries requiring additional information with other departments in a cooperative, efficient, and professional manner.
• Perform other related assigned duties as necessary to complete the Primary Job Responsibilities as described above.
• Foster, encourage, and reward a fun, positive, successful, values-based culture!

Minimum Requirements :

The company will provide equal employment and advancement opportunity within the context of its unique business environment without regard to race, color, religion, gender, gender identity, gender expression, age, national origin, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status, or any other status protected under federal, state, or local law or ordinance.