Vaccine Customer Representative - San Diego, CA
Account representative job in Santa Fe, NM
The Vaccine Customer Representative (VCR) supports customers by providing clinical information on our Company's vaccines, as well as education and resources. They do this to support customer operational and financial needs such as reimbursement information and contract adherence in an effort to help the provider or system increase their immunization rates among appropriate patients and help protect them from vaccine preventable diseases.
The Vaccine Customer Representative (VCR) is the primary point of contact for a variety of customers within their assigned geography. These customers may include health care providers such as physicians, nurses, pharmacists as well as quality directors, immunization managers, and office managers. Within their geography there are a diverse set of health care locations that they will call upon in order to execute their role including: clinics, health departments, integrated delivery systems, and hospitals. The VCR is a key member of the local Customer Team that works collaboratively with other field-based employees such as the Vaccine Key Customer Leader (VKCL), Vaccine Medical Affairs Leader (VMAL), Region Medical Director (RMD) as well as other members of the extended team.
**Territory Information:**
+ This territory covers San Diego, CA including but not limited to National City, El Cajon, and El Centro.
+ The ideal location to reside is within this territory.
+ Travel (%) varies based on candidate's location within the geography.
**The primary activities include:**
+ Engaging in balanced product sales presentations with Health Care Providers and Health Care Business Professionals to align customer needs and our Company's vaccine attribute in accordance with product labeling, and CDC and professional society recommendations.
+ Providing Company Vaccine management with updates on customer needs as it relates to helping them improve patient health outcomes, customer feedback, marketplace dynamics, and progress towards quality goals.
+ Providing customers with key insights by keeping apprised of professional and health care environment knowledge through self-study of company-provided scientific, product and marketplace information, attendance at product workshops and conferences, as well as consistent and ongoing review of our Company's promotional materials.
+ Utilizing analytical skills and tools to engage customers in quarterly business reviews regarding their vaccine contract to educate customers on the best ways to maximize their contract performance across the Company portfolio.
+ Assisting customers with education to improve their organization's immunization rates through adherence to quality-based programs using appropriate tools such as Vaccine IQ.
+ Regularly monitoring their business performance against objectives using company provided tools.
+ Developing a territory level business plan that focuses on improving immunization rates with assigned customers in accordance with Our Company's policies, standards, and ethics.
+ Maintaining product knowledge and certification on the entire Company vaccine portfolio along with knowledge of the CDC immunization schedule for both pediatric and adult vaccines.
**Specifically:**
+ Within select customer accounts, acts as primary point of contact for the customer, meet with key customers/personnel to maintain understanding of their current practice structure, business model, and key influencers (Managed Care Organization/payers, employers, state policy), and their patients' needs. Identifies business opportunities and makes information available to relevant stakeholders to support the identified immunization needs.
+ For select customer accounts, coordinate with our Company's customer team (Account Executives, Integrated Delivery System team, Solutions support teams, etc.) to outline customer strategy for interactions/relationships aimed at improving immunization rates.
**Position Qualifications:**
**Education:**
+ Bachelor's Degree with 0-3 years Sales experience **OR** a minimum of high school diploma with at least 4 years of relevant work experience which could include: professional sales, experience in marketing, military, or healthcare/scientific field (pharmaceutical, biotech, or medical devices).
**Required Skills:**
+ Demonstrated aptitude to excel in current or previous educational or professional roles
+ Ability to work both independently and within a team environment
+ Strong organizational and time management skills
+ Excellent interpersonal and communication skills
**Other Requirements:**
+ Valid Driver's license
**Preferred Skills/Experience:**
+ Ability to convey technical concepts accurately and clearly
+ Prior experience working in a technical/scientific field or healthcare environment
+ Previous sales, account management, consultative, or customer service experience
+ Experience developing and executing a plan for engaging customers and meeting customer needs
+ Understanding of Marketing/Sales &/or Marketing/Sales Support Functions/Operations
+ Ability to analyze metrics to assess progress against objectives
+ Vaccine's experience
**Required Skills:**
Account Management, Account Management, Business Management, Business Opportunities, Business Performance Management, Business Reviews, Customer Accounts, Customer Experience Design, Customer Experience Management, Customer Needs Assessments, Customer Relationship Management (CRM), Customer Service Management, Customer Strategy, Health Economics, Immunizations, Interpersonal Relationships, Lead Generation, Managed Care, Market Analysis, Medical Affairs, Product Knowledge, Sales Forecasting, Sales Metrics, Sales Operations, Sales Pipeline Management {+ 4 more}
**Preferred Skills:**
Current Employees apply HERE (*****************************************************
Current Contingent Workers apply HERE (*****************************************************
**US and Puerto Rico Residents Only:**
Our company is committed to inclusion, ensuring that candidates can engage in a hiring process that exhibits their true capabilities. Please click here (*************************************** if you need an accommodation during the application or hiring process.
As an Equal Employment Opportunity Employer, we provide equal opportunities to all employees and applicants for employment and prohibit discrimination on the basis of race, color, age, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability status, or other applicable legally protected characteristics. As a federal contractor, we comply with all affirmative action requirements for protected veterans and individuals with disabilities. For more information about personal rights under the U.S. Equal Opportunity Employment laws, visit:
EEOC Know Your Rights (******************************************************************************************
EEOC GINA Supplement
We are proud to be a company that embraces the value of bringing together, talented, and committed people with diverse experiences, perspectives, skills and backgrounds. The fastest way to breakthrough innovation is when people with diverse ideas, broad experiences, backgrounds, and skills come together in an inclusive environment. We encourage our colleagues to respectfully challenge one another's thinking and approach problems collectively.
Learn more about your rights, including under California, Colorado and other US State Acts (**********************************************
**U.S. Hybrid Work Model**
Effective September 5, 2023, employees in office-based positions in the U.S. will be working a Hybrid work consisting of three total days on-site per week, Monday - Thursday, although the specific days may vary by site or organization, with Friday designated as a remote-working day, unless business critical tasks require an on-site presence.This Hybrid work model does not apply to, and daily in-person attendance is required for, field-based positions; facility-based, manufacturing-based, or research-based positions where the work to be performed is located at a Company site; positions covered by a collective-bargaining agreement (unless the agreement provides for hybrid work); or any other position for which the Company has determined the job requirements cannot be reasonably met working remotely. Please note, this Hybrid work model guidance also does not apply to roles that have been designated as "remote".
The salary range for this role is
$77,700.00 - $122,300.00
This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. An employee's position within the salary range will be based on several factors including, but not limited to relevant education, qualifications, certifications, experience, skills, geographic location, government requirements, and business or organizational needs.
The successful candidate will be eligible for annual bonus and long-term incentive, if applicable.
We offer a comprehensive package of benefits. Available benefits include medical, dental, vision healthcare and other insurance benefits (for employee and family), retirement benefits, including 401(k), paid holidays, vacation, and compassionate and sick days. More information about benefits is available at ****************************************************** .
You can apply for this role through **************************** (or via the Workday Jobs Hub if you are a current employee). The application deadline for this position is stated on this posting.
**San Francisco Residents Only:** We will consider qualified applicants with arrest and conviction records for employment in compliance with the San Francisco Fair Chance Ordinance
**Los Angeles Residents Only:** We will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance
**Search Firm Representatives Please Read Carefully**
Merck & Co., Inc., Rahway, NJ, USA, also known as Merck Sharp & Dohme LLC, Rahway, NJ, USA, does not accept unsolicited assistance from search firms for employment opportunities. All CVs / resumes submitted by search firms to any employee at our company without a valid written search agreement in place for this position will be deemed the sole property of our company. No fee will be paid in the event a candidate is hired by our company as a result of an agency referral where no pre-existing agreement is in place. Where agency agreements are in place, introductions are position specific. Please, no phone calls or emails.
**Employee Status:**
Regular
**Relocation:**
No relocation
**VISA Sponsorship:**
No
**Travel Requirements:**
10%
**Flexible Work Arrangements:**
Remote
**Shift:**
Not Indicated
**Valid Driving License:**
Yes
**Hazardous Material(s):**
n/a
**Job Posting End Date:**
12/13/2025
***A job posting is effective until 11:59:59PM on the day** **BEFORE** **the listed job posting end date. Please ensure you apply to a job posting no later than the day** **BEFORE** **the job posting end date.**
**Requisition ID:** R376883
Customer Service Representative - Bilingual - HCB Ops
Account representative job in Santa Fe, NM
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
**This position is designated for bilingual candidates. Fluency in English and Spanish is required.**
**Position Summary**
Customer Service Representative is the face of Aetna and impacts members' service experience by manner of how customer service inquiries and problems via telephone, internet or written correspondence are handled. Customer inquiries are of basic and at times complex nature.
+ Engages, consults and educates members based upon the member's unique needs, preferences and under‐standing of Aetna plans, tools and resources to help guide the members along a clear path to care.
+ Answers questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors.
+ Triages resulting rework to appropriate staff.
+ Documents and tracks contacts with members, providers and plan sponsors. The CSR guides the member through their members plan of benefits, Aetna policy and procedures as well as having knowledge of resources to comply with any regulatory guidelines.
+ Creates an emotional connection with our members by understanding and engaging the member to the fullest to champion for our members' best health.
+ Taking accountability to fully understand the member's needs by building a trusting and caring relationship with the member.
+ Anticipates customer needs. Provides the customer with related information to answer the unasked questions, e.g. additional plan details, benefit plan details, member self-ser‐vice tools, etc.
+ Uses customer service threshold framework to make financial decisions to resolve member issues.
+ Explains member's rights and responsibilities in accordance with contract.
+ Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system.
+ Educates providers on our self-ser‐vice options; Assists providers with credentialing and re-credentialing issues.
+ Responds to re‐quests received from Aetna's Law Document Center regarding litigation; lawsuits Handles extensive file review requests.
+ Assists in preparation of complaint trend reports. Assists in compiling claim data for customer audits.
+ Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals.
+ Handles incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management. Performs review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible.
+ Performs financial data maintenance as necessary. Uses applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received.
+ As a call center inbound representative you will be responsible for taking inbound Brokerage calls to provide application status, contract and appointment status.
+ In addition you will review commission inquires, data entry, processing of Medicare contracts, appointments and verification of certification for external producers/agents to be eligible to market Medicare plans. May supplement the background check review and documentation process as well.
**Required Qualifications**
+ 6 months of Customer Service experience
+ Strong communication and empathy skills.
+ Ability to navigate multiple systems and tools.
**Preferred Qualifications**
+ Knowledge of health plan benefits and regulatory requirements. Prior experience in healthcare, insurance, or call center environments is highly valued.
**Education**
+ High School Diploma or GED
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$17.00 - $34.15
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
**Great benefits for great people**
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
+ **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .
+ **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
+ **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit *****************************************
We anticipate the application window for this opening will close on: 12/20/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
Senior Account Development Specialist (Level 3)
Account representative job in Santa Fe, NM
Job Description The Senior Account Development Representative bridges inside sales and account executive responsibilities, focusing on both generating new business and expanding existing client relationships within a defined territory or set of named accounts. This role involves proactive customer engagement, identifying new sales opportunities, and driving revenue growth by understanding customer needs and delivering tailored IT solutions in the federal government sector. The SADS serves as a key liaison between customers and the Wildflower technical team, ensuring alignment with customer needs while preparing for growth into a Strategic Account Executive role.
Essential Duties and Responsibilities:
Customer Relationships: Develop and maintain trust-based relationships with key customers and stakeholders. Understand their needs and provide tailored solutions to drive satisfaction and loyalty.
New Business Generation: Proactively identify and pursue new sales opportunities within assigned accounts or territories.
Sales Strategy: Search bid boards, conduct cold calls, emails, and outreach campaigns to identify and engage potential customers within the federal government space. Meet or exceed sales targets and performance metrics as outlined by management.
Collaboration: Collaborate with cross-functional teams to identify and implement strategic initiatives aimed at increasing customer engagement and revenue growth including Wildflower Solution Architects.
OEM Relationships: Strengthen existing OEM/SI relationships by creating a productive cadence of interaction around current and future sales opportunities. Support OEM registration processes by researching requirements, gathering necessary documentation, and ensuring timely submission.
Customer Quotations: Responsible for suggesting new and related products, explaining technical features, and creating sales quotes.
Continuous Education: Stay informed about industry trends, competitive landscape, product knowledge, and customer feedback to inform sales strategies.
Strategic Marketing: Collaborate with marketing team to develop and implement targeted strategies and campaigns that align with Wildflower needs, and drive sales growth.
Data Management and Documentation: Maintain important information and data accurately within our ERP system. Work with marketing team to utilize the designated CRM system to manage and track customer interactions, streamline pipelines, and effectively deliver personalized customer experiences.
Travel: Plan and execute quarterly travel to meet with customers, deliver presentations, and participate in key account reviews.
Any other duties needed to drive our Vision, fulfill our Mission, and abide by our Values.
Job Qualifications/Requirements:
A 2‐year college degree is required, or equivalent education and experience, along with advanced technical or managerial credentials.
4+ years of experience in sales within the technology industry, with at least 3 years' experience working with channel/OEM partners.
Stable track record of success in sales, with 2-3 years consecutive, successful sales experiences developing strategic customer relationships.
Must have worked in a quota-bearing capacity and understand the various stages of the sale cycle.
Highly adaptable to changes in business direction, products, and needs both from a partner perspective and customer perspective.
Proven ability to articulate a portfolio, selling across products, solutions, and services.
Demonstrable over-achievement in all areas - personal, quota, and development.
Strong customer service skills with a proven ability to build and maintain relationships.
Strong understanding of the federal procurement process and compliance requirements.
Must have excellent verbal and written communication skills and the ability to conduct and present meetings via voice and video conferencing.
Excellent organizational skills and attention to detail.
Ability to work independently and deal with multiple projects simultaneously.
Excellent analytical, strategic thinking, and time management skills.
Proficiency in ERP, CRM tools, and Microsoft Office Suite.
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Funeral Sales Representative
Account representative job in Santa Fe, NM
at Rivera Family Funeral home
Quality leads you can trust so you can earn what you want.
You're an ambitious professional who always strives to hit your goals. But, without qualified leads and community connections, are those goals even possible?
Imagine what you could do with a dedicated team supporting your efforts with qualified leads, appointment setting, and strategic marketing resources!
You'll be working in a recession-proof industry so the sky's the limit to growing your earning potential!
What you'll do (and why you'll love doing it)
Make what you want: Earn competitive compensation that you control by closing pre-set appointments (typical average of $65,000 - $75,000/annually with no earning cap)
Live Flexibly: Enjoy the freedom of being your own boss, setting your schedule and balancing work and life priorities
Capitalize on our support: Lead generation programs and strategic marketing programs provided at no cost - you'll be representing one of our premier funeral home partners in qualified meetings with clients that typically last 90 mins
Experience recognition of a lifetime: Precoa Escapes Sales Incentive Trips for you and your family
Advance your career: A current life insurance license or ability to obtain one will give you professional credentials to use now and in the future
Be independent, not alone
As an Advanced Funeral Planner, you have a dedicated team of over 50 agents setting appointments and helping you know as much as possible about your clients. Precoa's field management provides you with organizational tools, mentorship, and coaching to succeed in a unique and growing industry.
You can focus on what you do best - connecting with clients to plan their final wishes and provide peace of mind for their loved ones.
If you have these skills, we want to talk with you!
Current life insurance license or ability to obtain one
Bilingual abilities (Spanish/English) preferred!
5+ years consultative sales experience is a bonus!
Strong interpersonal sales abilities, listening skills and relationship development skills
Ability to effectively close pre-set appointments
Excellent listening and persuasion skills, lead generation, and networking abilities
Ready for work to change your life?
About Precoa:
Precoa is a national sales and marketing company within the preneed insurance/funeral planning industry. We establish partnerships with premier, market-leading funeral homes and implement a lead generation and marketing system called Proactive Preneed. Our goal is to help as many families as possible prearrange and put into place intentional plans to help their families begin healing at the time of loss.
Auto-Apply907 Customer Service Representatives (CSR)
Account representative job in Pecos, NM
Job Details LPT 907 - PECOS, NMDescription
Provide excellent customer service. If two employees are on duty and only one is running a cash register while the other performs stocking or cleaning duties, all such work should be set aside if more than two customers line up at the register in operation; the second register should be opened immediately in order to provide fast and friendly service to the customer.
Complete all shift duties as assigned.
All employees are expected to safeguard the company's assets unless their own physical safety, or that of co-workers or customers, may be jeopardized:
Follow company policies with regard to cash control, proper safe operation.
Follow correct vendor check-in procedures.
Complete all end of shift paperwork.
Pay immediate attention to any spill or other hazardous condition.
Other duties may be assigned from time to time by the Store Manager.
Qualifications
Ability to read, understand and write the English language at the eighth-grade level, including the ability to hear the spoken word.
Eighth-grade level math competency in order to make change, complete shift reports, and account for numbers of a variety of products during vendor check-in.
Sufficient visual acuity to check identification and process money orders.
Ability to read and understand instructions for operating electronic cash registers, gas consoles, and other equipment.
Account Associate - State Farm Agent Team Member
Account representative job in Santa Fe, NM
Job DescriptionBenefits:
License reimbursement
Bonus based on performance
Competitive salary
Flexible schedule
Opportunity for advancement
Paid time off
Training & development
ROLE DESCRIPTION:
As Account Associate - State Farm Agent Team Member for Belinda Maez-Ferrero - State Farm Agent, you are vital to our daily business operations and customers success. You grow our agency through meaningful customer relations and acting as a liaison between customer needs and agency departments. You improve the lives of our customers by proactively marketing relevant products and services.
Grow your career as you better your community. As an attentive, sociable, and sales-minded professional, we are eager to have you on our team.
RESPONSIBILITIES:
Manage customer accounts and update information in the database.
Assist customers with policy changes and inquiries.
Process insurance claims and follow up with customers on claim status.
Coordinate with underwriters to ensure timely policy issuance.
QUALIFICATIONS:
Strong organizational skills and attention to detail.
Excellent customer service and communication skills.
Previous experience in insurance or a related field preferred.
Account Associate - State Farm Agent Team Member
Account representative job in Santa Fe, NM
Job DescriptionBenefits:
401(k) matching
Bonus based on performance
Company parties
Flexible schedule
Opportunity for advancement
Paid time off
Training & development
Agent Team Member
ROLE DESCRIPTION:
As an Agent Team Member for Michelle Cole State Farm, you are vital to our daily business operations and customers success. You grow our agency through meaningful customer relations and acting as a liaison between customer needs and agency departments. You improve the lives of our customers by proactively marketing relevant products and services.
Grow your career as you better your community. As an attentive, sociable, and sales-minded professional, we are eager to have you on our team.
RESPONSIBILITIES:
Manage customer accounts and update information in the database.
Assist customers with policy changes and inquiries.
Process insurance claims and follow up with customers on claim status.
Coordinate with underwriters to ensure timely policy issuance.
QUALIFICATIONS:
Strong organizational skills and attention to detail.
Excellent customer service and communication skills.
Previous experience in insurance or a related field preferred.
Account Associate - State Farm Agent Team Member
Account representative job in Santa Fe, NM
Job DescriptionBenefits:
License reimbursement
Bonus based on performance
Competitive salary
Flexible schedule
Opportunity for advancement
Paid time off
Training & development
ROLE DESCRIPTION:
As Account Associate - State Farm Agent Team Member for Garrett Seawright - State Farm Agent, you are vital to our daily business operations and customers success. You grow our agency through meaningful customer relations and acting as a liaison between customer needs and agency departments. You improve the lives of our customers by proactively marketing relevant products and services.
Grow your career as you better your community. As an attentive, sociable, and sales-minded professional, we are eager to have you on our team.
RESPONSIBILITIES:
Manage customer accounts and update information in the database.
Assist customers with policy changes and inquiries.
Process insurance claims and follow up with customers on claim status.
Coordinate with underwriters to ensure timely policy issuance.
QUALIFICATIONS:
Strong organizational skills and attention to detail.
Excellent customer service and communication skills.
Previous experience in insurance or a related field preferred.
Representative II, Accounts Receivable
Account representative job in Santa Fe, NM
Schedule: Monday - Friday, 8:00 AM - 4:30 PM EST **_What Contract and Billing contributes to Cardinal Health_** Contracts and Billing is responsible for finance related activities such as customer and vendor contract administration customer and vendor pricing, rebates, billing (including drop-ships), processing chargebacks and vendor invoices and developing and negotiating customer and group purchasing contracts.
+ Demonstrates knowledge of financial processes, systems, controls, and work streams.
+ Demonstrates experience working collaboratively in a finance environment coupled with strong internal controls.
+ Possesses understanding of service level goals and objectives when providing customer support.
+ Demonstrates ability to respond to non-standard requests from vendors and customers.
+ Possesses strong organizational skills and prioritizes getting the right things done.
**The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as dictated below with guidance and support from AR & Billing leadership teams.**
**_Responsibilities_**
+ Processes claims: investigates insurance claims; and properly resolves by follow-up & disposition.
+ Verifies patient eligibility with secondary insurance company when necessary.
+ Bills supplemental insurances including all Medicaid states on paper and online.
+ Mails all paper claims.
+ Acts as a subject matter expert in claims processing.
+ Manages billing queue as assigned in the appropriate system.
+ Manages and resolves complex insurance claims, including appeals and denials, to ensure timely and accurate reimbursement.
+ Processes denials & rejections for re-submission (billing) in accordance with company policy, regulations, or third-party policy.
+ More challenging claim cases
+ Investigates and updates the system with all information received from secondary insurance companies.
+ Ensures that all information given by representatives is accurate by cross referencing with the patient's account, followed by using honest judgement in any changes that may need to be made.
+ Processes denials & rejections for re-submission (billing) in accordance with company policy, regulations, or third party policy.
+ Updates patient files for insurance information, Medicare status, and other changes as necessary or required.
+ Keeps email inbox requests up to date at all times; checks for new messages on an hourly basis.
+ Mentors new hires; assists
+ Assists management and team lead with motivating and coaching employees to succeed as needed.
+ Maintains accurate and detailed notes in the company system.
+ Adapts quickly to frequent process changes and improvements.
+ Is reliable, engaged, and provides feedback as to improve processes and policies.
+ Attends all department, team, and weekly company meetings as required.
+ Appropriately routes incoming calls when necessary.
+ Meets company quality Meets patient service quality standards.
**_Qualifications_**
+ 2-3 years of experience, preferred
+ High School Diploma, GED or equivalent work experience, preferred
**_What is expected of you and others at this level_**
+ Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments
+ In-depth knowledge in technical or specialty area
+ Applies advanced skills to resolve complex problems independently
+ May modify process to resolve situations
+ Works independently within established procedures; may receive general guidance on new assignments
+ May provide general guidance or technical assistance to less experienced team members
**Anticipated hourly range:** $15.00 per hour - $22.57 per hour
**Bonus eligible:** No
**Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being.
+ Medical, dental and vision coverage
+ Paid time off plan
+ Health savings account (HSA)
+ 401k savings plan
+ Access to wages before pay day with my FlexPay
+ Flexible spending accounts (FSAs)
+ Short- and long-term disability coverage
+ Work-Life resources
+ Paid parental leave
+ Healthy lifestyle programs
**Application window anticipated to close:** 12/15/2025 *if interested in opportunity, please submit application as soon as possible.
The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity.
_Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._
_Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._
_To read and review this privacy notice click_ here (***************************************************************************************************************************
Part Time Sales Rep - Paid Weekly - Entry Level
Account representative job in Santa Fe, NM
Vector Marketing is looking to fill part time positions. Our sales representatives present Cutco through one on one appointments. We offer a minimum base pay so our reps dont feel pressured to make a sale - instead we ask them to focus on providing excellent customer service to people. We believe the quality of the product speaks for itself.
We provide flexible schedules for anyone looking to make some extra income around their current work schedule, family obligations, or classes.
What we offer:
Excellent pay$25.00 base-appt, pay per presentation not based on sales. Commissions available based on performance. Paid weekly.
Solid training We teach our reps how to do well in this role
before
they start and offer continued support and additional training as time goes on.
Flexible scheduling Reps can work around classes, finals, internships, other jobs, or family commitments.
Product - We sell Cutco products that are used in the home focusing on the kitchen and some gardening tools as well. Previous experience & knowledge about home goods or sales isnt required.
Locations Reps interview online, then work locally after training. Meetings and training are held in the office.
What we require:
Enjoy working with people
At least eighteen or seventeen and a high school graduate
Conditions apply
Willing to learn and apply new skills.
What makes a good candidate:
This entry level position is a good fit for people who are looking to supplement their current work schedule. Whether you work as a receptionist, cashier, fast food, server, or in retail we can help work around your busy schedule. If you are a student looking to work around classes or need a flexible schedule this semester break, our opportunities can work around your needs. It doesnt matter if you have a Bachelors Degree, an Associates Degree, or no degree at all we can train you to do well with us. We encourage applicants of all ages and experience, as we do not discriminate on the basis of an applicants age.
People who do well with us have experience in just about every field you can imagine - customer service, stocked shelves in a warehouse, as a waiter or waitress at a restaurant, administrative assistant, in a call center, temp job, cashier, communications
And yes this means our training is so good that if your previous work was as a barista, a line cook, a cashier, or stocking shelves, you can do well here.
If you think you would be a great fit for our team, fill out a quick application and a receptionist will text you about setting up a time to meet with a manager.
RequiredPreferredJob Industries
Sales & Marketing
Service BDC Representative
Account representative job in Santa Fe, NM
Job Description
As a Service BDC Representative at Chevrolet Cadillac of Santa Fe, you will be responsible for providing exceptional customer service and support to our service department. This is a full-time, administrative role in the fast-paced and exciting auto industry. As an individual contributor, you will play a crucial role in ensuring our customers have a positive experience with our dealership and maintain long-term relationships with them.
Compensation & Benefits:
This is a full-time, hourly position with competitive pay and benefits package including medical, dental, and vision insurance, 401(k) retirement plan, paid time off, and employee discounts on vehicles and service.
Responsibilities:
- Serve as the first point of contact for our service department, answering phone calls, emails, and online inquiries in a prompt and professional manner
- Schedule service appointments for customers and maintain accurate and up-to-date service records
- Ensure customer satisfaction by following up on service appointments and addressing any concerns or issues that may arise
- Utilize dealership management systems to input and track customer information, appointment details, and service orders
- Maintain a positive and professional attitude at all times, providing exceptional customer service to all customers
- Assist with organizing and maintaining the service department, including scheduling, filing, and inventory management
- Collaborate with the service and sales teams to ensure efficient and effective communication and customer service
Requirements:
- High school diploma or equivalent
- Previous experience working in a customer service or administrative role, preferably in the automotive industry
- Excellent communication and interpersonal skills
- Strong organizational and multitasking abilities
- Proficient in computer systems and software, including Microsoft Office and dealership management systems
- Ability to work in a fast-paced environment and handle multiple tasks simultaneously
- Must be able to work full-time, including some evenings and weekends as needed
EEOC statement:
Chevrolet Cadillac of Santa Fe is an equal opportunity employer and values diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. We are committed to promoting a dynamic and inclusive workplace where employees of all backgrounds can thrive.
Customer Access Representative
Account representative job in Santa Fe, NM
JOB CATEGORY: COMMUNITY HEALTH CENTER / ADMINISTRATION
This position provides receptionist duties for the center and performs a variety of clerical duties including patient appointments and registration, management of patient flow, billing, and payment collections.
REQUIREMENTS
EDUCATION AND/OR EXPERIENCE:
High school diploma or general education degree (GED) required.
Six months experience in healthcare setting OR one year administrative and/or customer service background.
Computer experience required; ability to work with Windows-based programs strongly preferred.
Experience or training in customer service industry preferred.
Experience in medical billing preferred.
Bilingual Spanish / English or Navajo / English preferred.
CERTIFICATES, LICENSES, REGISTRATIONS:
If required to assist with state Centennial Care / Medicaid enrollment and/or NM Health Insurance Exchange (NMHIX) enrollment, must successfully complete required state and federal health insurance enrollment assistance training programs and obtain related certifications before providing enrollment services and maintain current while required to provide these services.
SCREENING REQUIREMENTS:
This position requires successful completion of an initial post-offer of employment:
According to PMS Human Resources Policy 205.006, “Healthcare Personnel Testing & Immunization Requirements,” this position must comply with required testing and immunizations. Testing and immunizations including TB, Hepatitis B (consent or waiver), Tdap, MMR, and Varicella, will be available at the employee's PMS health center. Influenza vaccines will be required according to dates set by the CDC and NMDOH.
If required to assist with NM Health Insurance Exchange (NMHIX) enrollment, this position requires successful completion of a Criminal Records Check conducted by the NM Insurance Exchange as a part of their assistor's application process, prior to providing these services.
$100 EMPLOYEE REFERRAL BONUS
BONUSES
All bonuses subject to tax withholding and eligibility requirements.
ABOUT PMS
Founded in 1969, PMS is a non-profit organization with over 1,300 employees providing services at 100+ locations in New Mexico.
Our diverse services include primary care, dental, behavioral health, early childhood education, supportive living, and senior programs.
We concentrate our resources on meeting the needs of underserved areas of New Mexico.
We operate the largest network of federally qualified health centers in the state.
PMS is not affiliated with Presbyterian Healthcare Services, Presbyterian Hospitals or Presbyterian Health Plan.
WHY PMS?
Mission-driven organization
Competitive salaries
Nine paid holidays and generous PTO
Medical, dental & vision insurance
Free Life & LTD coverage
Free discretionary pension plan contribution
Employee recognition and engagement activities
Robust training program
Tuition Reimbursement
EOE/AA/M/F/SO/Vet/Disability
Auto-ApplyCustomer Service Representative - Santa Fe, NM
Account representative job in Santa Fe, NM
Kedia Corporation connects people with what they want on a global scale. We are committed through use of innovation to create exceptional user experiences. Kedia is engineering. Using cutting edge techniques, we have defined the way business will continue future operations. Our company provides a challenging, fast paced, and growth oriented foundation to develop and empower people to innovate in the business services field
Job Description
Tasks
Confer with customers by telephone or in person to provide information about products or services, take or enter orders, cancel accounts, or obtain details of complaints.
Keep records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken.
Check to ensure that appropriate changes were made to resolve customers' problems.
Determine charges for services requested, collect deposits or payments, or arrange for billing.
Refer unresolved customer grievances to designated departments for further investigation.
Review insurance policy terms to determine whether a particular loss is covered by insurance.
Contact customers to respond to inquiries or to notify them of claim investigation results or any planned adjustments.
Resolve customers' service or billing complaints by performing activities such as exchanging merchandise, refunding money, or adjusting bills.
Compare disputed merchandise with original requisitions and information from invoices and prepare invoices for returned goods.
Obtain and examine all relevant information to assess validity of complaints and to determine possible causes, such as extreme weather conditions that could increase utility bills.
Tools
used in this occupation:
Autodialers
- Autodialing systems; Predictive dialers
Automated attendant systems
- Voice broadcasting systems
Automatic call distributor ACD
- Automatic call distribution ACD system
Scanners
Standalone telephone caller identification
- Calling line identification equipment; Dialed number identification systems DNIS
Technology
used in this occupation:
Contact center software
- Avaya software; Multi-channel contact center software; Timpani Contact Center; Timpani Email
Customer relationship management CRM software
- Austin Logistics CallSelect; Avidian Technologies Prophet; SSA Global software; Telemation e-CRM
Electronic mail software
- Astute Solutions PowerCenter; IBM Lotus Notes; Microsoft Outlook
Network conferencing software
- Active Data Online WebChat; eStara Softphone; Parature eRealtime; Timpani Chat
Spreadsheet software
- Microsoft Excel
Knowledge
Customer and Personal Service
- Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
Clerical
- Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and other office procedures and terminology.
English Language
- Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
Qualifications
Skills
Active Listening
- Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
Speaking
- Talking to others to convey information effectively.
Service Orientation
- Actively looking for ways to help people.
Persuasion
- Persuading others to change their minds or behavior.
Reading Comprehension
- Understanding written sentences and paragraphs in work related documents.
Critical Thinking
- Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
Writing
- Communicating effectively in writing as appropriate for the needs of the audience.
Coordination
- Adjusting actions in relation to others' actions.
Social Perceptiveness
- Being aware of others' reactions and understanding why they react as they do.
Negotiation
- Bringing others together and trying to reconcile differences.
Abilities
Oral Comprehension
- The ability to listen to and understand information and ideas presented through spoken words and sentences.
Oral Expression
- The ability to communicate information and ideas in speaking so others will understand.
Speech Clarity
- The ability to speak clearly so others can understand you.
Speech Recognition
- The ability to identify and understand the speech of another person.
Written Expression
- The ability to communicate information and ideas in writing so others will understand.
Near Vision
- The ability to see details at close range (within a few feet of the observer).
Problem Sensitivity
- The ability to tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing there is a problem.
Written Comprehension
- The ability to read and understand information and ideas presented in writing.
Deductive Reasoning
- The ability to apply general rules to specific problems to produce answers that make sense.
Inductive Reasoning
- The ability to combine pieces of information to form general rules or conclusions (includes finding a relationship among seemingly unrelated events).
Additional Information
If this sounds like the right job for you, then use the button below to submit your resume. We look forward to receiving your application.
Customer Service Representative
Account representative job in Santa Fe, NM
Job Description
Our office is
quickly growing
and we need someone who we can train to fit in our office puzzle! The position offered is full time. Our Customer Service Representative needs to
exceed customer service standards
to current clients while also
assisting prospects as they call in
.
No prior experience is necessary Apply for the position today by completing the form and completing the assessment.
Benefits
Hands on Training
Career Growth Opportunities
Responsibilities
Schedule appointments for sales staff to meet prospective customers.
Provides on-going support to insurance clients as needed.
Responds to all inquiries, cancellation requests, and sales requests within a specified timeframe.
Stay up-to-date on industry market trends and best practices.
Assess and identify the wants and needs of your customer(s) over the phone.
Participate in regular team meetings and brainstorming sessions.
Attend training and continuing education courses.
Handle customer renewals.
Requirements
Possess a genuine willingness to learn, be intuitive and resourceful and be coachable.
Possess an upbeat, positive and enthusiastic attitude.
Be a great self-starter with a sense of urgency.
Create relationships from a cold start.
Be a fantastic presenter.
Proficiency to multi-task, follow-thru and follow-up.
Excellent Communication/interpersonal skills.
Customer Service Representative - State Farm Agent Team Member
Account representative job in Santa Fe, NM
Job DescriptionBenefits:
401(k)
401(k) matching
Competitive salary
Dental insurance
Flexible schedule
Health insurance
Paid time off
Training & development
Vision insurance
Position Overview
Are you outgoing and customer-focused? Do you enjoy working with the public? If you answered yes to these questions, working for a State Farm independent contractor agent may be the career for you! State Farm agents market only State Farm insurance and financial service products.
Responsibilities
Establish customer relationships and follow up with customers, as needed.
Provide prompt, accurate, and friendly customer service. Service can include responding to inquiries regarding insurance availability, eligibility, coverages, policy changes, transfers, claim submissions, and billing clarification.
Use a customer-focused, needs-based review process to educate customers about insurance options.
As an Agent Team Member, you will receive...
Simple IRA
Group Life Insurance Benefits
Hourly pay plus commission/bonus
Hourly pay
Health benefits
Flexible hours
Valuable experience
Growth potential/Opportunity for advancement within my agency
Requirements
Excellent communication skills - written, verbal and listening
Organizational skills
Self-motivated
Detail oriented
Proactive in problem solving
Dedicated to customer service
Able to learn computer functions
Ability to work in a team environment
Ability to multi-task
Ability to effectively relate to a customer
Property and Casualty license (must be able to obtain)
Life and Health license (must be able to obtain)
If you are motivated to succeed and can see yourself in this role, please complete our application. We will follow up with you on the next steps in the interview process.
This position is with a State Farm independent contractor agent, not with State Farm Insurance Companies. Employees of State Farm agents must be able to successfully complete any applicable licensing requirements and training programs. State Farm agents are independent contractors who hire their own employees. State Farm agents employees are not employees of State Farm.
POSITION COULD DEVELOP INTO FULL-TIME SALARIED JOB.
Customer Service Rep / Pizza Maker Store (06531)
Account representative job in Santa Fe, NM
Responsibilities: ● Greeting customers and taking orders with a smile! ● Operating the cash register and collecting payment from customers. ● Making consistent products within Domino's Pizza guidelines. ● Maintaining a clean and organized work environment
● Maintain a professional appearance
Qualifications
● Minimum 16 years old
● Reliable transportation to and from work
● Comfortable engaging with customers over the phone and face-to-face
Additional Information
Pay & Benefits:
● Flexible schedule (Work as few as 4 hrs per week)
● Medical & Dental Insurance
● 401K
● Employee Discount
● Advancement opportunities
Customer Service Rep
Account representative job in Santa Fe, NM
This employee communicates with customers for the purposes of answering questions, resolving problems, determining ongoing and additional product/service needs, and supporting compliance to physician direction. JOB FUNCTIONS:
Communicates with customers via inbound and outbound manual calls and outbound calls generated via automated dialer system
Assesses customer need for additional products/services
Assesses customer compliance with physician orders
Answers questions and provides customer education regarding products/services
Documents calls in computerized record keeping system
Enters customer orders in computerized system
Verifies and updates demographic information such as address and telephone number in computerized records
Retail Customer Service Representative
Account representative job in Santa Fe, NM
Benefits:
Flexible schedule
Opportunity for advancement
Paid time off
Retail Customer Service Representative - Benefit and Perks
Competitive Compensation
Flexible Scheduling
Hard work, collaboration, humanity, fun, and laughter
Career path development
A PostNet Retail Customer Service Representative is responsible for assisting customers with all store services and products. Operates the point-of-sale system, copiers/printers, rental computers, and other store equipment. Other duties as assigned. May help to train and mentor Customer Service Representatives. The Ideal Retail Customer Service Representative Candidate Will Have:
Previous customer service or sales experience in a retail environment
Exceptional customer service skills
Ability to translate customer requirements into final products or services
Assist in handling customer complaints and problems in a professional manner
Multitasking - must have the ability to simultaneously process multiple tasks
Effective verbal and written communication skills
Strong attention to detail
Outstanding time management and organizational skills
A high school diploma or equivalent required
Valid driver's license required
Proficient with Microsoft Office applications, Google Suite, Windows operating system, and other computer hardware and software
Ability to work flexible hours
Some supervisory skills preferred
Notary Public certification may be required
Retail Customer Service Representative - Daily Tasks:
Assists customers with shipping and packaging services, printing estimates/orders, and other services offered by franchise owner
Assists customers with their product and service need in person, through email, and by phone
Processes customer sales through the point-of-sale system
Up-sells, cross-sells, and actively participates in marketing and promotional initiatives
Opens and closes the center, cash register, and other center systems
Assists management in maintaining, ordering, and stocking inventory
Maintains the center consistent with established standards
Interacts with UPS, FedEx, DHL, and USPS couriers, other vendors, and all store staff
Sorts and deposits mail in private mailboxes
Captures, complete tasks, and organizes Virtual Mail
Retail Customer Service Representative - Role Requirements:
Must be able to stand behind a sales counter for extended periods of time
Must be able to lift at least 50 pounds
Must be able to communicate clearly with customers by email, by phone, and in-person
May be required to operate a motor vehicle
Must perform all duties in a safe and efficient manner
Spanish speaking is a plus but not required.
Company OverviewSince 1993, PostNet has provided small businesses and consumers with high-quality printing and shipping solutions that make life easier. Each franchise is independently owned by local owners that are keenly focused on helping the businesses and individuals in their community succeed.PostNet has nearly 700 locations across North America, Central America, South America, and Africa. At PostNet, our people enable us to achieve our purpose. Also, through diversity and inclusion efforts, we ensure our global workplaces are dynamic, supportive of all our team members, and representative of our customers and communities.
Apply today! Compensation: $15.00 per hour
At PostNet, we offer careers for everyone! Whether you are just starting out, looking for that next great growth opportunity, or seeking a change, we have exciting roles to suit you.
We pride ourselves on our training programs in management, sales, operations, print, signs, design, and marketing. Join us with or without experience, and we will succeed together as a team!
We invite EVERYONE to apply!
*PostNet centers (locations) are independently owned and operated. The posted positions are offered by individual franchisees who interview, hire, manage and pay the employees hired for positions in a specific local location (center) through their specific business.
Auto-ApplyRepresentative, Dental Provider Services
Account representative job in Santa Fe, NM
Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service.
KNOWLEDGE/SKILLS/ABILITIES
This role serves as the primary point of contact between Molina Health plan and the Provider community that serves Molina members. It's an external-facing, field-based position requiring a high degree of job knowledge, communication, and organizational skills to successfully engage high volume, high visibility providers (including senior leaders and physicians) to ensure provider satisfaction, education on key Molina initiatives, and improved coordination and partnership.
* Under minimal direction, works directly with the Plan's external providers to educate, advocate, and engage as valuable partners, ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service.
* Conducts regular provider site visits within assigned region/service area. Determines own daily or weekly schedule, as needed to meet or exceed the Plan's monthly site visit goals. A key responsibility of the Representative during these visits is to proactively engage with the provider and staff to determine, for example, non-compliance with Molina policies/procedures or CMS guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members.
* Provides on-the-spot training and education as needed, which may include counseling providers diplomatically, while retaining a positive working relationship.
* Independently troubleshoots problems as they arise, making an assessment when escalation to a Senior Representative, Supervisor, or another Molina department is needed. Takes initiative in preventing and resolving issues between the provider and the Plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters.
* Initiates, coordinates, and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians. Such meetings would occur to discuss and resolve issues related to utilization management, pharmacy, quality of care, and correct coding, for example.
* Independently delivers training and presentations to assigned providers and their staff, answering questions that come up on behalf of the Health plan. May also deliver training and presentations to larger groups, such as leaders and management of provider offices (including large multispecialty groups or health systems, executive level decision makers, Association meetings, and JOC's).
* Performs an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives. Examples of such initiatives include administrative cost effectiveness, member satisfaction - CAHPS, regulatory-related, Molina Quality programs, and taking advantage of electronic solutions (EDI, EFT, EMR, Provider Portal, Provider Website, etc.).
* Trains other Provider Services Representatives as appropriate.
* Role requires 80%+ same-day or overnight travel. (Extent of overnight travel will depend on the specific Health Plan and its service area.).
JOB QUALIFICATIONS
Required Education
Bachelor's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting.
Required Experience
* 2 - 3 years customer service, provider service, or claims experience in a managed care setting.
* Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to, fee-for service, capitation, and various forms of risk, ASO, etc.
Preferred Education
Bachelor's Degree.
Preferred Experience
* 5 years' experience in managed healthcare administration and/or Provider Services.
* 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $21.16 - $46.42 / HOURLY
* Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Dental Network Service Representative
Account representative job in Santa Fe, NM
****** MUST BE A US CITIZEN ****** Looking for someone with Dental Provider Relations to service United Concordia Dental's (UCD's) clients by recruiting, training and servicing quality dental networks in assigned territory in a remote and mobile work environment. Manage network contracts including negotiations, contract development/renewal and financial reimbursement. Meet with dentists and office personnel to act as the intermediary between the organization and UCD. Respond to contractual and payment issues both internally and externally. Ensure compliance with contractual terms through regular on-site audits. Apply an active role in network management, training, monitoring and enforcement of company policies and procedures while increasing provider efficiencies.
ESSENTIAL RESPONSIBILITIES
+ Identify and initiate contact with prospective providers. Develop and follow up on leads in an established time frame, while incorporating a sound business plan strategy to support and execute recruitment efforts that include existing and prospective client needs and provider resignations/terminations. Customize participating dental agreement forms for execution, analyze provider changes, facilitate provider file updates and draft confidentiality agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees.
+ Analyze and develop network retention strategies for follow up services to providers by establishing and maintaining contact and rapport with dental staff members, office managers, insurance coordinators, hygienists and dentists throughout an assigned territory by scheduling face-to-face meetings with dental offices. Formally present and effectively communicate UCD's administrative and claim guidelines and policies, benefits of participation, fee schedules, plan designs, competitive position, product development, network options, strategic partnerships, utilization review, local/national client demographics and dentist distribution. Interpret and articulate contractual language and address questions regarding participation with providers, network share/leasing arrangements, opt in/out options, reimbursement methods, compensation models, including pay for performance and value added benefits. Meet with all identified practices in assigned territory to review practice financial and quality performance.
+ Perform effective on-site visits through educating providers on the financial advantages and marketing incentives of participation. Train dental office staff on the use of automated services to ensure they utilize various means of automated communication, as well as, claims and electronic data interchange and electronic funds transfer. Collaborate with sales and customer service to respond to client/broker/member inquiries regarding provider contract, claim/member issues or provider file/record/directory discrepancies. Consult with dental director/dental advisers regarding clinical-related questions and policies, as well as, current dental terminology (CDT) changes, to resolve provider inquiries within a mutually agreed timeframe.
+ Act as subject matter expert with recommendations and data supporting development of network and sales strategy and support of leasing contract negotiation. Develop and maintain leasing revenue targets. Update network lease risk strategy in response to all market changes.
+ Communicate and maintain effective working relationships both internally and externally (providers, dental industry, organized dentistry and dental consultants) keeping management informed on related healthcare industry issues/topics. Support competitive position in the marketplace by staying abreast of changes to the business climate. Monitor provider reimbursement methods and PPO/DHMO/EPO network models and communicate changes to provider community and leadership team.
+ Develop and manage process improvement initiatives designed to maintain URAC accreditation of all network practices associated with government programs using continuous quality improvement principles. Conduct, collect and analyze data from office site visits and reviews to continually improve the care and service to members and provide recommendations to internal customer supporting quality improvement programs. Train dental office staff and providers on all updates to quality assurance guidelines, with state and local regulations and URAC accreditation requirements. Conduct audits as needed.
+ Other duties as assigned or requested.
**EDUCATION**
**Required**
+ High School Diploma/GED
**Preferred**
+ Bachelor's Degree - Business
**EXPERIENCE**
**Required**
+ Must Be a US Citizen
+ 3 - 5 years of experience in the healthcare/insurance industry or professional experience in presenting concepts and influencing others in varying audiences
**Preferred**
+ Dental Provider Relations
+ 3-5 years of experience as Dental Office Manager or Dental Hygienist
LICENSES OR CERTIFICATIONS
Required
+ None
Preferred
+ None
**SKILLS**
+ Written and oral communication skills
+ Time management and organizational skills
+ Knowledge of ADA/CDT codes and general dental terminology
+ Negotiation skills
+ Ability to analyze situations, determine points of relevance and proper course of actions
Language Requirement (other than English)
None
Travel Required
0% - 25%
**PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**
Position Type
Remote
Teaches / trains others regularly
Does Not Apply
Travel regularly from the office to various work sites or from site-to-site
Occasionally
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
**Pay Range Minimum:**
$50,200.00
**Pay Range Maximum:**
$91,200.00
_Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at *****************************
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J272322