Full-Time

Call Center Representative

Posted on 11/14/2025

Deadline 11/17/26
Presbyterian Healthcare Services

Presbyterian Healthcare Services

5,001-10,000 employees

Not-for-profit health system and health plan

Compensation Overview

$23.76/wk

Albuquerque, NM, USA

In Person

Category
Customer Experience & Support (1)
Requirements
  • High school diploma plus one to three years office/business experience; call center experience preferred and/or is currently demonstrating customer service skills, meeting current department metric and attendance guidelines within department.
  • Demonstrated ability to communicate effectively in person and via telephone with members, employer groups, brokers, physicians, and physician office staff.
  • Written communication skills as well as business writing and presentation skills are required.
  • Requires strong organizational skills, ability to create, sort and analyze reports (Excel, Access, etc) and system processes.
  • A thorough knowledge of reimbursement methodologies i.e. DRG, Relative Value Systems, Per Diem, Fee schedule, Capitation, etc and some knowledge of risk sharing programs helpful.
  • Some knowledge of customer relationship management and Facets, as well as any other databases that may be used PHS Enterprise wide.
  • Demonstrated ability to function effectively as a team member.
  • Requires ability to retain plan details and basic medical terminology.
Responsibilities
  • As applicable to all Contact Centers throughout PHS EnterpriseNote: Customer = member or patient. Partner = provider or practitioner office, broker or employer. A customer or partner is anyone you may come into contact with either by telephone, email, E-Business or in-person contacts.
  • Respond to routine and emergent customer calls, triage requests, and determine appropriate action to immediately respond to critical patient care calls. Accurately communicate customers need through timely transfer of information to appropriate personnel and clinical staff, including entry of information into complex database systems and or nurse call system. Follow through with appropriate departments or vendors to ensure proper resolution and opportunities.
  • Monitor CDS alarm system that are connected to the organization. Includes operating several computer programs relating to dispatch and alarm systems by following established emergency procedures as assigned by department to maintain clear and concise communication with appropriate teams and clinical staff.
  • Respond to incoming calls routed through skill-based technology to meet quality standards and performance measurements Available to take calls at the scheduled time, and spends the appropriate amount of time taking calls throughout their shift to resolve contacts on initial encounters.
  • Develop and maintain positive customer relationships, delivering exceptional customer service that meets/exceeds expectations in all customer contacts/ service functions. Promote customer satisfaction/loyalty through quality contact and timeliness of responses.
  • Assess and prioritize multiple requests, escalating to appropriate department leads as necessary. Develop sense of urgency and knowledge of correct and immediate response for emergent environmental and safety situations and critical patient care situations (including falls and critical health problems).
  • Work effectively with cross-functional departments, understanding complexities and negotiating resolutions that may involve overlap of departmental responsibilities. Demonstrate patience and de-escalate interactions with frustrated customers. Respond to complaints with appropriate measures.
Desired Qualifications
  • Claims processing experience in managed care with possible enrollment experience is preferred.
Presbyterian Healthcare Services

Presbyterian Healthcare Services

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Presbyterian Healthcare Services is a not-for-profit health system in New Mexico that operates nine hospitals, a statewide health plan, and a growing multi-specialty medical group. It delivers integrated care through hospitals, clinics, and its health plan, offering Medicare Advantage, Turquoise Care Medicaid, and commercial plans to more than 580,000 members. It combines hospital services with insurance and primary care to provide coordinated health care across the state. Unlike many competitors, it is locally owned and nonprofit, serving as the state’s largest private employer with a mission to improve the health of patients, members, and the communities it serves.

Company Size

5,001-10,000

Company Stage

N/A

Total Funding

N/A

Headquarters

null

Founded

1908

Simplify Jobs

Simplify's Take

What believers are saying

  • UnityPoint Health merger preserves local brands while achieving administrative efficiencies.
  • Fitch expects significant revenue growth from higher Medicaid rates supporting improvement.
  • Chad Aduddell joins as executive, bringing 14 years CommonSpirit Health leadership experience.

What critics are saying

  • Fitch downgrade to AA- with negative outlook limits capital market access.
  • UnitedHealthcare contract expires June 1, 2026, risking out-of-network status.
  • Medicaid rate increases uncertain; state budget shortfalls eliminate projected revenue gains.

What makes Presbyterian Healthcare Services unique

  • Integrated delivery system with nine hospitals, health plan, and multi-specialty medical group.
  • Deployed GW RhythmX AI platform to 200 primary care clinicians for precision care.
  • Named best regional hospital by U.S. News & World Report 2021-22 rankings.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Disability Insurance

Wellness Program

Gym Membership

Company News

PR Newswire
Feb 3rd, 2026
Presbyterian Healthcare Services deploys GW RhythmX AI platform to 200 primary care clinicians

Presbyterian Healthcare Services has expanded its deployment of the GW RhythmX AI Precision Care Platform to 200 primary care clinicians across its system. The pilot programme identified over 200 conditions across more than 10,000 patient encounters and delivered 17,000 hyper-personalised treatment responses, reducing manual chart review time from hours to minutes. The platform integrates with Epic EHR, providing clinicians with consolidated clinical history, payer criteria and guideline-based recommendations during patient visits. Presbyterian, one of the Southwest's largest integrated delivery systems, emphasised the solution's ability to address clinical complexity whilst supporting value-based care arrangements. GW RhythmX's solutions are deployed across more than 150 health systems, reaching over 85 million patients. The company combines AI precision care technology with patient engagement capabilities.

Trinity Health System
Jan 5th, 2026
Market President Chad Aduddell to Depart in February

Market President Chad Aduddell to depart in february. After 14 years with the CommonSpirit ministry, Chad Aduddell is leaving his role as Market President of CHI St. Vincent to join Presbyterian Healthcare Services of New Mexico. His last day will be Feb. 15, 2026. OneSpirit want to extend its deepest gratitude to Chad for his leadership and the impact he has made on its patients and staff. Chad has served its ministry with dedication, and his contributions have been instrumental in shaping the Arkansas market into what it is today. During his tenure, Chad consistently championed an environment of collaboration, visibility, transparency and communication, aiming to achieve the highest quality care for its patients and communities. Under his leadership, CHI St. Vincent has consistently earned some of the highest engagement rankings across CommonSpirit Health. Its facilities have been recognized as a Best Place to Work, achieved Magnet and Pathways Designations and received multiple LeapFrog "A" ratings. Most recently, the Arkansas market was honored at the 2025 CommonSpirit Health Clinical Service Excellence Awards for Quality. Dr. William G. Jones will continue to serve as Market President in the interim. Here is a video message from Chad and Dr. Jones about this announcement:

ASBN Small Business Network
Jun 17th, 2024
How EOS transforms entrepreneurial businesses - Mike Paton | EOS Implementer

Author, speaker, and EOS Implementer(R) Mike Paton will join Presbyterian Hospital of Dallas to discuss this further.

Amazon
May 10th, 2024
Amazon supports and celebrates entrepreneurs for National Small Business Week-and every day

For example, last year Presbyterian Hospital of Dallas introduced the expanded Amazon Small Business Academy, a free digital resource for entrepreneurs to learn foundational skills to start, build, or launch their business.

Albuquerque Journal
May 7th, 2024
Serna to offer free behavioral health training

Serna Solutions is partnering with Presbyterian Healthcare Services - Community Health Department to offer the courses for professionals who work in mental health or substance abuse fields.

INACTIVE