Customer Service Representative I

Job Description Thevision of Colorado Accessis to have healthy communities transformed by the care that people want at a cost we can all afford. Our mission is to partner with communities and empower people through access to quality, affordable care. Why should you consider a career with Colorado Access? We are a Colorado-based company, working to improve the health of our state. We care for individuals, families, and children who receive health care under Child Health Plan Plus (CHP+) and Health First Colorado (Colorado's Medicaid Program). Our focus is driving improvements in quality, member experience, outcomes, and cost. We are a mission-driven organization whose foundation is built by our vision and supported by our values. Find work/life balance:We offer PTO, floating holidays, nine company paid holidays, a hybrid work environment, an Employee Assistance Program and a 401K. Be a part of something bigger and make an impact: We serve the underserved and most vulnerable populations in our community through access to quality and affordable health care. No matter what you do for Colorado Access, you are impacting our community and making a difference. Sharpen your skills, learn, and grow: We support your continued development through tuition reimbursement, leadership training, promotion opportunities, performance evaluations, employee recognition, and a language pay stipend. What you will do: Answer incoming calls with a customer-focused approach while maintaining professionalism and courtesy at all times. Maintain full availability during scheduled shifts, remaining accessible throughout the workday to ensure timely service. Research, resolve, and document customer inquiries, concerns, and issues accurately and efficiently. Provide clear and accurate information and education related to benefits, coverage, policies, claims, and general inquiries. Utilize available resources such as policies, procedures, training materials, handouts, databases, and multiple systems to complete daily work. Document all interactions clearly and thoroughly in the E-Plus system or other required systems. Conduct outbound calls for follow-ups, benefits information, claims clarification, and other customer-related needs as assigned. Respond to email inquiries sent to the Customer Service inbox in a professional, clear, and HIPAA-compliant manner when assigned. Assist members with basic policy updates such as contact information changes and general account questions. Provide general guidance on how to file claims and what documentation is required. Follow a daily schedule for breaks and lunches as assigned. Maintain regular attendance and punctuality as an essential function of the role. Consistently meet or exceed performance, quality, and customer service standards set by department leadership. What you will bring: Education: High school diploma or equivalent required. Experience: Minimum of 2 years’ customer service experience is required. Experience in medical insurance and Medicare and Medicaid eligibility and enrollment is highly preferred. Bilingual in Spanish/English is highly preferred. Knowledge, Skills, and Abilities: Ability to work within a call center environment and answer inquiries in a professional manner. Requires the ability to identify and appropriately handle grievances and appeals, and to facilitate quality outcomes and/or resolutions for the benefit of all applicable parties. Demonstrates support for the company’s mission, vision and values. Position requires excellent written and verbal communication skills. Must be proficient in Microsoft office applications (Word, Excel, PowerPoint, Outlook, SharePoint) with ability to work with a variety of project management tools. May be required to manage multiple priorities and projects with tight deadlines. Licenses/Certifications: A valid driver's license and proof of current auto insurance will be required for any position requiring driving. Together we will be: an innovative and collaborative team who supports each other, the employees and vision of the company to reach our goals individually, together and as an organization. Pay, Perks and Benefits at Colorado Access: The compensation for this position is $51,600.00 - $53,500.00annually and is a non-exempt (hourly) position. Colorado Access has provided a compensation range that represents its good faith estimate of what Colorado Access may pay for the position at the time of posting. Colorado Access may ultimately pay more or less than the posted compensation range. The salary offered to the selected candidate will be determined based on factors such as the qualifications of the selected candidate, departmental budget availability, internal salary equity considerations, and available market information, but not based on a candidate’s sex or any other protected status. Medical, dental, vision insurance that starts the first day of the month following start date. Supplemental insurance such as critical illness and accidental injury. Health care and dependent care flexible spending account options. Employer-paid basic life insurance and AD&D (employee, spouse and dependent). Short-term and long-term disability coverage. Voluntary life insurance (employee, spouse, dependent). Paid time off Retirement plan Tuition reimbursement (based on eligibility). Annual bonus program (based on eligibility, requirements and performance). Remote #J-18808-Ljbffr