Job Description

Act as a solution-focused, service advisor for BCBSNC customers, employer groups and providers, with the ability to successfully service more complex healthcare insurance needs. Demonstrates proficiency with added product, functional, and/or technical knowledge to better provide consistent, reliable and customized stakeholder service interactions in a highly efficient and effective manner. Strengthen the BCBSNC brand by developing, managing and expanding customer relationships at service levels that meet and exceed customer expectations.

• Successfully utilizes added knowledge of product types, functional and/or technical skills to provide solution focused service to our customers on more complex insurance questions and issues.
• Successfully able to understand and communicate complex concepts to members, providers and colleagues in verbal and written form.
• Display leadership through all actions both internally and externally.
• Support and be committed to the mission, vision and values of the company by delivering seamless, energetic and innovative service solutions to increase stakeholder satisfaction and retain customers.
• Utilize probing and creative problem solving as well as critical thinking and the ability to analyze more complex and ambiguous information to resolve customer inquiries on first contact.
• Document corrective measures and detailed customer information reelevate to each customer contact and provide instructions as needed to internal business areas to ensure prompt resolution and response to customer inquiries.
• Ensures final disposition of each inquiry in a timely manner.
• Identify and obtain information and records from customers, members, providers and/or employer groups to correct/update information, claims and membership records when necessary.
• Recognize patterns of inconsistent and/or inaccurate claims filing practices among customers and providers, educate customers and providers on acceptable BCBSNC practices and policies.
• Perform phone/email outreach to BCBSNC vendors and business partners to resolve service issues.
• Identify, understand and anticipate customers’ unexpressed needs and concerns in a caring manner.
• Work collaboratively with business partners to further optimize customer, employer group and provider relations by identifying opportunities to promote stakeholder programs. Promote programs, making sound decisions to apply the most appropriate “stakeholder centric” course of action to respond to needs.
• Educate and encourage customers on use of alternative delivery channels (i.e. self service, web).
• Identify and communicate process, product or systems improvement opportunities to improve the overall stakeholder experience.
• Interface with local, state and federal governmental entities and plan participants regarding BCBSNC products, services and policies.

Hiring Requirements

• High school diploma or GED

• 0-2 years of experience in related field.

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$41,600.00 - $66,561.00

Skills

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JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com