Call Center Service Associate-12

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.

Responsibilities:

• Receive customer inquiries via phone, fax, mail, e-mail, etc. If necessary, probe for additional helpful information (i.e. member ID, claim number, name, etc.) in order to effectively handle inquiry.
• Review computer systems and/or other reference materials to complete verification process.
• Initiate investigation process based on the nature of the inquiry (claim, member information, benefits, enrollment, appeals, etc.).
• Utilize available resources to quickly and efficiently resolve or redirect inquiries in accordance with prescribed departmental process.
• Accurately document customer inquiries and actions taken in accordance with departmental quality guidelines to ensure appropriate follow up.
• Follow up on unresolved issues in a timely manner, escalating call trends to management.
• Deliver an excellent customer service experience while meeting quality and production standards.
• Perform other relevant tasks as assigned by management..

Education/Experience:

• High School Diploma/GED required
• Some experience in a call center or customer service role within the health insurance industry preferred.

Knowledge:

• Medical terminology and medical billing coding preferred

Skills and Abilities:

• Excellent Customer Service skills including the ability to manage and diffuse irate calls
• Ability to work in a high pressure, fast pace environment
• Keyboarding proficiency
• PC proficiency
• Strong verbal and written communication
• Interpersonal skills (i.e. active listening)
• Investigative and analytical skills
• Ability to multitask
• Time management skills
• Flexibility and adaptability
• Ability to work effectively within a team environment

*The employer may require an employee to pass a test(s) as part of determining whether the applicant meets the minimum qualifications for the job.

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware

Salary Range:

This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:

• Comprehensive health benefits (Medical/Dental/Vision)

• Retirement Plans

• Generous PTO

• Incentive Plans

• Wellness Programs

• Paid Volunteer Time Off

• Tuition Reimbursement

Disclaimer:
This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.