Blue Cross and Blue Shield Association logo

Customer Services Concierge Support, Intermediate

Blue Cross and Blue Shield Association
  • Oakland, CA
    2 days ago

    Job Description

    Your Role

    The Shared Advantage team is a multi-functional team providing services and support for third-party administrators (TPA), including claims processing, high dollar review, written correspondence, client services concierge phone support, e-mail and correspondence,. The Claim Processor, Intermediate will report to the Shared Advantage supervisor. In this role you will learn to process and adjust simple and complex claims, apply return files, and respond to written correspondence.

    Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

    Your Knowledge and Experience

    • Requires High School Diploma or GED or 1 year of additional relevant experience in lieu of diploma
    • Requires 1-3 years prior relevant experience
    • Ability to problem-solve and resolve complex claims issues
    • Maintain professionalism and a positive attitude
    • Be dependable, reliable, responsible and can work independently
    • Have excellent interpersonal communication skills and work well within a team

    Hybrid Virtual Work

    This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.

    Your Work

    In this role, you will:

    • Be experienced in back-end processing; proficient in resolving complex edits using available documents/job aids with minimum direction
    • Experience front-end processing and difficult adjustments
    • Be given special processing assignments; coordinate with other departments for resolution if needed
    • Understand fundamentals of end-to-end (life of a clam) claims processing
    • Perform established performance metrics
    • Compose correspondence to answer claims/provider inquiries in writing
    • Support Blue Shield''s mission of being a great place to do meaningful work
    • Drive and support a positive team culture

    Your Work

    In this role, you will:

    • Be experienced in back-end processing; proficient in resolving complex edits using available documents/job aids with minimum direction
    • Experience front-end processing and difficult adjustments
    • Be given special processing assignments; coordinate with other departments for resolution if needed
    • Understand fundamentals of end-to-end (life of a clam) claims processing
    • Perform established performance metrics
    • Compose correspondence to answer claims/provider inquiries in writing
    • Support Blue Shield''s mission of being a great place to do meaningful work
    • Drive and support a positive team culture

    Numbers & Facts

    LocationOakland, CA
    IndustryInsurance
    Company Size2,000 to 2,499 employees
    Websitehttps://www.bcbs.com/about-us/careers

    About Company

    At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry. We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.

    Skills

    • Claims Processingunmatched
    • Communication Skillsunmatched
    • Cross-Functionalunmatched
    • Customer Support/Serviceunmatched
    • Interpersonal Skillsunmatched
    • Leadershipunmatched
    • Mail Processingunmatched
    • Performance Metricsunmatched
    • Problem Solving Skillsunmatched
    • User Interface/Experience (UI/UX)unmatched
    • Work From Homeunmatched
    • Writing Skillsunmatched

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