Seasonal Reach or Order Picker Equipment Operator

Customer Service Representative - Work from Home in New Mexico

IBEX · Centralia, WA

Jumpstart Your Career with Ibex! Work From Home in NEW MEXICO!! Jumpstart Your Career with Ibex! Ibex is where your career journey starts with energy, teamwork, and endless opportunities! Whether you're just starting out or ready for something new, we've got your back with paid training that sets you up for success. Our vibrant team thrives on support, good vibes, and leaders who truly listen. You'll make real connections, build new skills, and grow your career in a place that celebrates you. About the Role As a Customer Service Agent, you will be responsible for assisting members with inquiries related to health insurance coverage, claims, benefits, and provider networks. You will provide support via phone, email, and chat while ensuring compliance with HIPAA regulations and company policies. We're looking for enthusiastic individuals with a can-do attitude. Even if you don't meet every qualification, we encourage you to apply. We value potential as much as experience. 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. Qualifications • 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. Requirements: • Must be 18 years or older • High school diploma or equivalent • Must reside in the state of New Mexico Why Ibex? • Paid training • A culture that celebrates YOU • Opportunities for growth and advancement • A team that's got your back

Job Summary Responsible for performing telephonic or face-to-face clinical assessments for the identification, evaluation, coordination, and management of member's needs, including physical health, behavioral health, social services and long-term services and supports. Identifies membersfor high-risk complications and coordinates care in conjunction with the member and the health care team. Manages members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. Obtains a thorough and accurate member history to develop an individual care plan. Establishes short- and long-term goals in collaboration with the member, caregivers, family, natural supports, physicians; identifies members that would benefit from an alternative level of care or other waiver programs. The RN has overall responsibility to develop the care plan for services for the member and ensures the member's access to those services. May assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within benefits structure or through extra-contractual arrangements, as permissible. Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on the development of care management treatment plans. May also assist in problem solving with providers, claims or service issues. Directs and/or supervises the work of any LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals other than an RN, in coordinating services for the member by, for example, assigning appropriate tasks to the non-RN clinicians, verifying and interpreting member information obtained by these individuals, conducting additional assessments, as necessary, to develop, monitor, evaluate, and revise the member's care plan to meet the member's needs, and reviewing and providing input on the non-RN clinicians' performance on a regular basis. Assists in meeting member needs by referring members to internal and external resources. Provide follow up with internal and external resources, providers, and state programs. Coordinate with and participate in ICT meetings with Nursing Facility Staff, member, Responsible Party, treating physicians, therapists, and any other applicable parties. Coordinate and assist with the transition to the community through the Money Follows the Person (MFP) process for any member who indicates a desire to leave the nursing facility. Marginal Functions Provide input and/or data to direct supervisor/manager related to any internal or external mandatory audit or reporting. Serve as mentor, subject matter expert or preceptor to new staff. Involved in process improvement initiatives. Assist in problem solving with providers, claims or service issues. Community Health Choice's Core Competencies • Customer Focus • Reliability and Dependability • Honest and Integrity • Change Management • Teamwork • Impact/Influence + Strategic Vision • People/Team Development Minimum Qualifications Education/Specialized Training/Licensure: Requires a current unrestricted RN license in Texas, Graduate of an accredited school of nursing. Bachelors degree in nursing preferred. CCM Work Experience (Years and Area): 3-4 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role; or any combination of education and experience, which would provide an equivalent background. 1 year experience working with population who receive waiver services,1 year experience working with persons with disabilities/chronic conditions and Long-Term Services & Supports. Management Experience (Years and Area): N/A Software Proficiencies: Microsoft Office, Clinical documentation platforms, Internet Other: Local travel required. Reliable transportation with valid driver's license with good driving record

Job Title This is a remote position but will need onsite training in Mishawaka Indiana. Shift: PRN/Days - 8 hr shift Considering local candidates only!!! Why Choose Saint Joseph Health System? At Saint Joseph Health System, our values guide every decision we make. Even when challenges arise, we remain committed to our mission: caring for every person who needs us. We invest in our people, our technology, and our capabilities so we can continue delivering exceptional, compassionate care to our communities. What We Offer • Tuition reimbursement for all full-time and part-time colleagues starting on day one • Comprehensive benefits beginning day one (Medical, Dental, Vision, PTO, Life Insurance, STD/LTD, and more) • Retirement savings plan with employer match • Generous paid time off program plus 7 paid holidays • No mandatory overtime • Employee referral incentive program • Access to state-of-the-art equipment, unlimited CEUs, and a supportive team-focused work environment What You Will Do • Conduct clinical reviews of patient records to evaluate medical necessity, appropriateness of admission, treatment, and length of stay across all payor types • Apply standardized criteria, regulatory guidelines, and insurance requirements to support reimbursement and compliance • Collaborate with physicians, nursing staff, and interdisciplinary teams to ensure appropriate resource utilization and care planning • Review admissions and ongoing patient cases; recommend or escalate cases that do not meet criteria to leadership or the Utilization Review Committee • Facilitate timely discharges, transfers, and recertifications when level of care is no longer appropriate • Partner with Medicare, Medicaid, and private insurers to ensure accurate documentation and reimbursement processes • Respond to denials and authorization changes by reviewing medical records and communicating outcomes to care teams and patients • Identify trends and utilization concerns; contribute to performance improvement and quality initiatives • Maintain accurate records, compile reports, and support utilization review program operations • Provide education to clinical staff on documentation requirements, coverage guidelines, and utilization processes • Support compliance with all regulatory, accreditation, and organizational standards • Participate in committee meetings and assist in development of utilization review plans and processes What You Will Need • Graduate of an accredited Registered Nurse (RN) program; Bachelor's Degree in Nursing preferred • Active RN license (state-specific requirement applies) • Minimum of 2 years of acute care nursing experience • Prior utilization review, case management, or payer review experience preferred • Strong knowledge of Medicare, Medicaid, and commercial insurance guidelines • Solid understanding of clinical care practices, diagnoses, treatment modalities, and hospital operations • Excellent communication skills with the ability to collaborate effectively across teams • Strong analytical and critical thinking skills to assess clinical appropriateness and compliance • Proficiency in computer systems and Microsoft Office applications • Ability to manage multiple priorities in a fast-paced healthcare environment • Flexibility to adapt to changing schedules, workflows, and departmental needs Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Schedule: Full-Time | Flexible Scheduling Options Guaranteed Hours: Yes (varies by assignment) About the Opportunity We are seeking a licensed Licensed Practical Nurse (LPN/LVN) to provide skilled nursing care under the direction of an RN or physician. This role offers flexibility across a variety of healthcare environments. Both local and travel contracts are available, with supportive placement and clear expectations. What You'll Do • Deliver nursing care within LPN/LVN scope of practice • Administer medications and treatments as ordered • Monitor patient conditions and report changes • Assist with patient education and daily care needs • Document care accurately and in a timely manner Qualifications • Active (or pending) LPN/LVN license • Graduate of an accredited practical nursing program • New graduates welcome for select assignments • Strong communication and organizational skills Compensation & Benefits • Competitive weekly pay packages • Guaranteed hours (assignment-dependent) • First-day medical, dental, and vision benefits • Housing stipend and meals & incidentals (travel roles) • Mileage reimbursement (when applicable) • License reimbursement • 401(k) plan • Short- and long-term disability • Weekly direct deposit Why Work With Us • Supportive recruiter partnership • Transparent contracts and pay • Nationwide placement opportunities • Clinician-first culture