Based on established guidelines, the Intake Specialist processes a variety of internal and external member/provider requests and transactions,. Receives, screens, and enters data in preparation for review. Complies with timeliness standards and reduces unpaid claims and rework by accurately processing requests. May also assist on special projects as needed.
This role is designated as Remote Flex – no standard weekly in-person onsite expectations. There may be opportunities to meet on campus up to 2 times per year.
What You’ll Do
Process a variety of requests, inquiries and transactions via phone, email, fax, and mail
Review requests to ensure accuracy
Support internal & external customers via phone or email
Document all pertinent information related to the call/inquiry, attach supporting information as applicable and if unable to resolve route to appropriate area for follow up as applicable
Gather and analyze data to provide feedback to Team Leads on employee development needs and/or specific providers requiring education on prior approval or pre-certification process
Screen inquiries to determine if authorization is required
Verify member benefits and eligibility and/or provider setup
Maintain and update Service Requests and research incorrect or missing information
Triage and assign all incoming inquiries in a timely, efficient manner throughout the day to appropriate staff
Provide clinical review outcome notification to members and providers (verbal and written)
What You Bring
High school diploma or GED
3+ years of experience in related field
Bonus Points
Prior call center experience, strongly preferred
Excellent verbal and written communication skills
WhatYou’llGet
The opportunity to work at thecutting edgeof health care delivery with a teamthat’sdeeply invested in the community
Work-life balance, flexibility, and the autonomy to dogreat work
Medical, dental, and vision coverage along withnumeroushealth and wellness programs
Parental leave and support plus adoption and surrogacyassistance
Career development programs and tuition reimbursement for continued education
401k match including an annual company contribution
WhereYou’llWork
Our Hybrid Flex approach is builton presencewith a purpose – giving you flexibility to work remotely with intentional in-person connection – that supports a workplacethat’sflexible, connected, and future focused.
In a Hybrid-Flex role,you’llwork in the office at least two days a week for collaboration and connection. In a Remote Flex role,you’llwork virtually, with a few in-office visits each year formeaningfulmoments that matter.
Whether your role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in anystateslistedonthis job posting. Onsite expectations will be discussed during the interview process.
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
It's an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care − in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians.
Blue Cross NC is a fully taxed, not-for-profit company headquartered in Durham, North Carolina. We serve more than 4.3 million members, and we employ more than 5,000 people across the country who are passionate about making health care better for all.
Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives.
Blue Cross NC is an independent licensee of the Blue Cross and Blue Shield Association.
