Customer Service Representative

ibex

. Assist members with inquiries related to health insurance coverage, claims, benefits, and provider networks .

Posted 10/6/2026full-timeRemote • New Mexico • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in health insurance coverage, claims processing, and compliance with HIPAA regulations while providing exceptional customer service. Proficient in managing high volumes of inquiries through various communication channels and maintaining accurate records in CRM systems.

Highest-signal resume keywords

Customer Service ExperienceHealth Insurance KnowledgeHIPAA ComplianceCRM ProficiencyStrong Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Health Insurance CoverageClaims ProcessingBilling TroubleshootingProvider Network GuidancePre-Authorization Support

Soft Skills

Problem-Solving SkillsIndependent Decision-MakingCalm Under PressureEffective CommunicationCollaboration

Tools & Technologies

CRM SystemsCustomer Support Platforms

Industry Keywords

HealthcareInsuranceComplianceState RegulationsCustomer Satisfaction

About the role

Key responsibilities & impact

Assist members with inquiries related to health insurance coverage, claims, benefits, and provider networks
Provide guidance on provider networks, referrals, and pre-authorizations
Troubleshoot and resolve issues related to billing, payments, and coverage
Ensure compliance with HIPAA regulations when handling sensitive member information
Collaborate with internal departments to resolve complex member concerns
Maintain accurate records of customer interactions and resolutions in CRM systems
Meet performance metrics such as response time, resolution rate, and customer satisfaction scores
Stay updated on policies, state regulations, and healthcare industry changes
Provide support via phone, email, and chat

Requirements

What you’ll need

Previous customer service experience, preferably in healthcare or insurance
Strong verbal and written communication skills
Independent decision-making and problem-solving skills with the ability to remain calm under pressure
Ability to handle high call/chat/email volumes effectively
Proficiency in computer applications, including CRM and customer support platforms
Ability to work flexible shifts, including weekends and holidays
Must be 18 years or older
High school diploma or equivalent
Must reside in the state of New Mexico

Benefits

Comp & perks

Paid training
Opportunities for growth and advancement
A culture that celebrates YOU
A team that’s got your back