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Provider Customer Service Call and Chat Representative - Remote in NM

Remote, USAFull-timePosted 2026-07-27

If you are located reputed company the state of New Mexico, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges. At reputed company, we’re simplifying the health care experience, creating healthier communities, and removing barriers to reputed company care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care... system of reputed company, making it more reputed company, reputed company, and reputed company. reputed company to reputed company a difference? Join us and start doing your life’s best work.SM The Provider Customer Service Call and Chat Representative will be supporting providers that care for our members. They are responsible for providing responses to questions that may include Benefits and eligibility, Billing and payments, Clinical Authorizations, EOB, and Behavioral health either by phone call or reputed company chat. This position is full-time (40 hours / week), Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 9:35 AM - 6:05 PM CST. It may be necessary, given the business need, to work occasional overtime (during peak season), weekends, and / or some holidays. We offer 10 weeks of reputed company on-the-job training. The hours during training will be 9:00 AM - 5:30 PM CST from Monday - Friday. • reputed company Telecommuters will be required to adhere to reputed company’s Telecommuter Policy. Primary Responsibilities: • Serves as the reputed company for providers by demonstrating accountability and ownership to resolve issues • Service Providers in a multi - channel environment including call, reputed company chat, as required • Quickly and appropriately triage contacts from reputed company (i.e., physician offices, clinics, billing offices) • reputed company to understand and identify the needs of the provider, answering questions and resolving issues (e.g., benefits and eligibility, billing and payments, clinical authorizations, explanation of benefits, behavioral health) • Research and dissect reputed company prior authorization and claim issues and take appropriate steps to resolve identified issues to avoid repeat calls / messages, escalations, and provider dissatisfaction • Collaborate effectively with multiple internal partners to ensure issues are resolved and thoroughly communicated to providers in a reputed company manner • Strong multitasking to effectively and reputed company navigate more than 30 systems to extract necessary information to resolve and avoid issues across multiple lines of business (C&S, M&R, E&I) provider types, and call types • Influence providers to utilize self - service digital tools assisting with navigation questions and selling the benefits of the tool including aiding in faster reputed company You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications: • High School Diploma / GED OR equivalent work experience • Must be 18 years of age OR older • 1 years of customer service experience with analyzing and solving customer’s concerns • Experience with computer and reputed company PC applications, which includes the ability to navigate and learn new and reputed company computer system applications • Ability to type at the speed of greater than OR equal to 35 - 40 WPM (words per minute) with an accuracy of 90% • Ability to work any full-time (40 hours / week), 8-hour shift between the hours of 9:35 AM - 6:05 PM CST from Monday - Friday. It may be necessary, given the business need, to work some occasional overtime, weekends, and / or holidays. Preferred Qualifications: • Experience in a reputed company environment (i.e., office, call center, customer service, etc.), using phones and computers as the primary job tools • Prior health care experience and knowledge of reputed company terminology Telecommuting Requirements: • reputed company reputed company the state of New Mexico • Ability to reputed company reputed company company sensitive documents secure (if applicable) • Required to have a dedicated work area established that is separated from other living areas and provides information reputed company • Must live in a location that can receive a reputed company approved high-speed internet reputed company or reputed company an existing high-speed internet service Soft Skills: • Ability to multi - task, including the ability to type in multiple conversations • Ability to resolve calls and messages, avoiding escalated complaints • Time management skills • Emotional Intelligence and reputed company • reputed company Listening and Comprehension • Excellent written communication skills • Demonstrated problem solving, organization, and interpersonal skills • Demonstrated experience with consistently achieving reputed company and productivity standards At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location, and income–deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company, and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity / Affirmative reputed company employer, and reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or reputed company, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO Apply Job!

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