Posted: Wednesday, February 7, 2018 3:14 PM
About Blue Cross
Founded in 1933, Blue Cross and Blue Shield of Minnesota is the largest health plan in the state. We have more members, the largest network of providers and more products and services than any other plan in Minnesota. From the beginning, Blue Cross has been an innovator with a mission of making a healthy difference in people's lives.
We understand the importance of finding a job that you truly enjoy - at a company that shares your values. We've made it easy to feel good about working at Blue Cross by encouraging volunteerism, valuing diversity and offering the flexibility you need to live a balanced life. We offer a suite of comprehensive medical and dental benefits as well as competitive pay, flexible work schedules and generous personal paid time off in addition to 20 hours of volunteer paid time off each year. We look forward to serving Minnesotans over the next 80 years and beyond. Join us and make a healthy difference through the work you do every day.
Description Summary 13;
This position is responsible for serving as a liaison, advocate and subject matter expert for the commercial and tribal books of business. The incumbent serves as first contact for the client and coordinates resolution of complex non:routine issues such as adverse benefit determinations, complex claims or BlueCard related inquires. The Client Advocate supports work within the appeals area and the customer service department.
:Advocates for client through research of internal systems, processes, policies and other internal departments to identify root cause and determine appropriate resolution option(s).
:Serves as first contact and technical expert for internal/external client; provides occasional on:site meetings as requested. Develops and maintains strong internal and external client relationships.
:Provides on:going education, via written or verbal responses, to client to clarify our position regarding company policies and procedures.
:Reviews reports and identifies trends in issues impacting client satisfaction. Works with other parts of the organization to identify root cause and recommend process and procedural changes to improve customer service.
:Serves as subject matter expert for internal employees and leadership regarding client (s).
:Acts as an internal support for service staff through examination complex issues, supporting first contact resolution and de:escalation of volatile client issues.
:Analyzes, develops and implements service center workflow and procedure changes.
:Provides supplemental and on:the:job training to new and existing Service Representatives/Health Guides in individual or group settings.
:Assigned other projects or duties as appropriate to meet business needs.
:Receives, processes, directs and closes appeals while managing the determination process through internal departments. Communicates appeal status to internal and external audiences.
:Handles customer service phone inquiries and is knowledgeable with regard to member and provider questions. Displays good customer service practices within these inquiries.
:High School Diploma or equivalency.
:2 years experiences in the health insurance industry operating in a customer service capacity
:Knowledge of health insurance regulations and/or provider agreements
:Excellent verbal and written communication skills with ability to express complex concepts in simple terms.
:Demonstrated skills in conflict resolution
:Demonstrated skills as an empathetic and compassionate communicator
:Demonstrated strong research, analytical , problem solving, and decision:making skills Demonstrated ability to handle midsize or large employer groups
:Ability to work independently and in a team environment
:Demonstrated ability in making timely service oriented decisions that align with corporate procedures and prot
• Location: Minneapolis / St. paul
• Post ID: 29035387 minneapolis