Customer Service Representative - Work from Home in New Mexico

Ibex is hiring a Customer Service Representative to assist members with health insurance coverage, claims, benefits, and provider network inquiries. The role provides support by phone, email, and chat while resolving member concerns and ensuring compliance with HIPAA regulations and company policies.

Responsibilities:

• 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

Requirements:

• 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
• Must be 18 years or older
• High school diploma or equivalent
• Must reside in the state of New Mexico