Additional Locations:Full Time Remote - Colorado, Full Time Remote - Florida, Full Time Remote - Georgia, Full Time Remote - Michigan, Full Time Remote - South Dakota, Full Time Remote - Texas, Full Time Remote - VirginiaJob DescriptionAct 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.START DATE: 4/22/2024
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 3+ years of experience in related field.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 North Carolina company with major operations centers in Durham and Winston-Salem. We employ more than 5,000 people who are passionate about health care, and we serve more than 4.3 million members.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.E-VerifyOur company uses E-Verify to confirm the employment eligibility of all newly hired employees. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify Overview (https://www.e-verify.gov/employees/e-verify-overview) for English or Visión General de E-Verify (https://www.e-verify.gov/es/empleados/vision-general-de-e-verify) for Español.Third Party Staffing AgenciesBlue Cross NC does not accept unsolicited resumes from any source other than directly from candidates. For the protection of all parties involved in the recruiting process, resumes will only be accepted from recruiters/agencies if a signed agreement is in place at the inception of the recruiting effort and authorized for a specific position. Unsolicited resumes sent to Blue Cross NC from recruiters/agencies do not constitute any type of relationship between the recruiter/agency and Blue Cross NC and do not obligate Blue Cross NC to pay fees if we hire from those resumes.