Please note. This role is a work at home role available for New Mexico residents only at this time.
Build your Career. Make a Difference. Presbyterian is hiring a skilled Call Center Representative to join our team.
Type of Opportunity: Full time
Job Exempt: No
Job is based: Reverend Hugh Cooper Administrative Center
Work Shift: Days (United States of America)
Responsibilities
Responsible for providing customer service for members and providers in all PHP benefit plans. Ensure callers receive service excellence when responding to telephone, written, Pres Online, E-Business, chat and in person inquires.
Some key responsibilities include
High school diploma plus one to three years office/business experience; call center experience preferred and/or is currently demonstrating customer service skills, meeting current department metric and attendance guidelines within department.
Claims processing experience in managed care with possible enrollment experience is preferred.
Demonstrated ability to communicate effectively in person and via telephone with members, employer groups, brokers, physicians, and physician office staff. Written communication skills as well as business writing and presentation skills are required.
Requires strong organizational skills, ability to create, sort and analyze reports (Excel, Access, etc) and system processes.
A thorough knowledge of reimbursement methodologies i.e. DRG, Relative Value Systems, Per Diem, Fee schedule, Capitation, etc and some knowledge of risk sharing programs helpful.
Some knowledge of CRM and Facets, as well as any other databases that may be used PHS Enterprise wide.
Demonstrated ability to function effectively as a team member. Requires ability to retain plan details and basic medical terminology.
Must be able to work cooperatively with other employees and function under pressure. Demonstrated ability to sustain quality standards. Must be able to prove ability to type 30 wpm with 90% accuracy.
Requirements
High school/GED diploma
One year office/business experience
Call Center experience preferred.
All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
Wellness
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services
Benefits
Health insuranceDental insuranceVision insurance
Additional Information
Location Address:
9521 San Mateo NE
Albuquerque, NM 87113-2237
Compensation Pay Range:
Minimum Offer $15.99
Maximum Offer $23.76
Now Hiring: Call Center Representative Health Plan
Phsorg · Reverend Hugh Cooper Administrative Center