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Company Name : Regence Blue Shield
Location : Washington State
Position : Regence (FEP) Customer Service Professional I or II DOE – Fully Remote
Job Description : Regence (FEP) Customer Service Professional I or II DOE**Remote within ID, OR, WA, or UT. Candidates outside of these states will not be considered.**Customer Service Professional I starting pay range $15.00 – $19.35 DOE and Location. **HR will reach out and provide specific information. **Position Starts: Monday, May 9, 2022**Positions closes to new applicants: Wednesday, March 23, 2022**APPLY TODAY: https://cambiahealth.wd1.myworkdayjobs.com/External/job/Tacoma-WA/Regence–FEP–Customer-Service-Professional-I-or-II-DOE—Fully-Remote-in-ID–OR–WA–and-UT_R-2133Primary Job PurposeDue to growth of our company and department, we are looking to expand our team. Bring your excellent customer service skills to the FEP (Federal Employee Program) Customer Service role! As an FEP Customer Service Professional, you will inform, educate, and assist members, providers, other health-care professionals, or other provider representatives on recorded phone lines regarding benefits, claims and eligibility.General Functions and OutcomesBe the primary contact between Cambia and the consumer.Successfully complete training period and meet dependability, timeliness, accuracy, quantity, and quality standards as established by department. Study, review and learn information, procedures, and techniques for responding to a variety of inquiries.Communicate with members, providers, healthcare professionals, agents/brokers, attorneys, group administrators, other member representatives, internal staff, and the general public with inquiries regarding benefits, claim payments and denials, eligibility, decisions, and other information through various media – oral, written and on-line communications.Quickly and accurately assess provider and member inquiries and requirements by establishing rapport to understand their service needs. Identify errors promptly and implement corrective steps to resolve.Determine benefit payments, maximum allowable fees, co-pays, and deductibles from appropriate contracts.Explain benefits, rules of eligibility and claims payment procedures, pre-authorizations, medical review and referrals, and grievance/appeal procedures to members and providers to ensure that benefits, policies, and procedures are understood.Maintain confidentiality and sensitivity in all aspects of internal and external contacts.Manage large volume of calls daily, prioritize follow-through and document member and provider inquiries and actions on tracking system and/or by completing logs. May generate written correspondence and process document requests.Work is subject to audit/checks and requires considerable accuracy, attention to detail and follow-through.Comply with the standards of the Federal Employee Program as they relate to the employee’s responsibility to meet BlueCross BlueShield Association (BCBSA) standards and company goals.Assist in identifying issues and trends to improve overall customer service.Minimum RequirementsProficient PC skills and prior experience in a PC environment.Knowledge of medical terminology and coding preferred.Understand and perform mathematical concepts and calculations.Communicate effectively orally and in writing, using accurate punctuation, spelling, grammar, and proof-reading skills.Strong customer-service skills, including courteous telephone etiquette.Make decisions and exercise good judgment in a sophisticated and constantly evolving environment.Learn, retain, and interpret new or evolving information, procedures, and policies and communicate them effectively.Work under stress and pressure and respond to inquiries with tact, diplomacy, and patience.Work in a team environment.Exercise discretion on critical and confidential matters.Demonstrate initiative in researching and resolving benefit and eligibility issues.Normally to be proficient in the competencies listed aboveCustomer Service Professional would have a high school diploma or equivalent and 6 months of customer service call center experience or 6 months of customer service experience such as insurance, retail, banking, restaurant, hospital medical office or other experience with extensive customer service contact or equivalent combination or education and experience.Work EnvironmentThis is a permanent remote positionOur call center is open 7am-6pm (PST) M-F. (Effective April 3, 2022 – Our call center will be open 7am-7pm (PST) M-F.)Job Type: Full-timePay: $15.00 – $19.35 per hourBenefits:401(k)401(k) matchingDental insuranceEmployee assistance programFlexible scheduleFlexible spending accountHealth insuranceHealth savings accountLife insurancePaid time offParental leaveTuition reimbursementVision insuranceSchedule:8 hour shiftDay shiftMonday to FridaySupplemental Pay:Bonus payEducation:High school or equivalent (Required)Experience:Customer Service: 1 year (Required)Work Location: Remote
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