Customer Service. Representative

Premera is committed to making healthcare work better, and it all starts with the Customer Service Representative. To help us continue to provide the best support for our customers, Premera is hiring additional Customer Service Representatives based out of Eastern Washington, Idaho, Oregon, Montana, Utah, Minnesota, Wisconsin, Tennessee, North Carolina, South Carolina, Georgia, Florida, Texas, and Arizona areas.

As a Customer Service Representative, you play an essential role in ensuring that the customers we serve are provided with a first call resolution.

The Customer Service Representative II (CSR II) plays an essential role in ensuring that the members and providers that Premera serve are provided with a first call resolution. Through applying Premera’s core values and competencies, the CSR II provides inbound and outbound customer service support while ensuring delivery of accurate, complete, and timely information. CSR II conducts research to provide claims status, investigates routine questions, escalates all call issues as required and thoroughly documents all member interactions. CSR II serves both Premera members and providers which includes doctors, facilities (clinics, hospitals, skilled nursing facilities, etc.), and vendors for multiple geographic locations.

What you will love:

Set schedule with consistency – Monday through Friday, 8-hour shift between 5 a.m. and 8 p.m. Pacific Time.

Twelve weeks of paid virtual training (100% attendance required).

A comprehensive benefits package that is designed to promote health and well-being. We offer an employer matched 401k, pension equity plan, and healthcare benefits. Healthcare benefits start day one. Premera offers a generous PTO policy in addition to 8 paid days off a year plus two floating holidays.

Tuition assistance for both undergraduate and graduate level classes.

Opportunities for RISE recognition. RISE, Premera's employee recognition program, is designed to celebrate colleagues' work, reinforce core competencies, and provide redeemable rewards.

A nationally recognized workplace as one of the best companies to work for that nurtures an employee culture where everyone can thrive.

What you will do:

Accountable for inbound and/or outbound phone-based customer service; provides first call and/or email resolution, de-escalate calls, as well as provides caller education, through clear and accurate exchange of information.

Follow-up, resolve and document issues in a timely manner. Route inquiries needing further investigation to the appropriate department and conduct routine research as needed.

Follow up on pended items and route incoming paperwork to correct departments for completion.

Work with highly sensitive information while maintaining Personal Protected Information (PPI) requirements.

Performs with reliable and consistent behaviors, performance goals and metrics, and attendance.

Other duties as assigned.

What you will bring:

• High School Diploma or GED. (Required)

• One years of customer service experience in related fields (Required) which includes the following:

  • Ability to defuse conflict and address customer concerns effectively with empathy and respect.

  • Demonstrated recent experience with Microsoft Office Suite or equivalent software platforms, including proficiency in navigating multiple screens and systems simultaneously while providing live call support.

  • Demonstrated ability to accept constructive feedback, adapt work practices accordingly, and implement changes to improve performance.

  • Ability to adapt communication style to broad audiences.

  • Ability to work a variety of shifts based on quality metrics (if shift bid applies).

What you will gain:

Deep healthcare and insurance knowledge, and an understanding of the provider ecosystem by working with clinics, hospitals, and vendors, and understanding their needs.

Regulatory and compliance awareness, including the handling of Personal Protected Information (PPI) and HIPAA-related practices.

Daily use of ALICE, Premera’s AI-powered virtual agent, to access procedures and guidance.

Career progression pathways: CSR roles feed into many other operations roles, evidenced by nearly 70% of promotions in Operations coming from Customer Service.