Medicare Advantage Customer Experience Representative-1

The customer experience representative provides a world class customer service experience through resolution of complex customer inquiries from members, providers, internal customers, and other Blue Plans related to Medicare Advantage (MA).

“This position is eligible to work onsite or remote in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment.” This role includes hours that can range from 8:00 a.m. to 8:00 p.m. and can include weekend hours from October 1 through March 31.

This position will have a start date of approximately May 12, 2025.

Why Join Us?

• Family Comes First: Total rewards package that promotes the idea of family first for all employees; including paid time off and family first leave.
• Professional Growth Opportunities: Advance your career with ongoing training and development programs both through our internal Blue University and external opportunities.
• Dynamic Work Environment: Collaborate with a team of passionate and driven individuals.
• Make a Positive Impact: Your work will directly contribute to the health and well-being of Kansans.
• Stability: 80 years of commitment, compassion, and community
• Lead and Inspire: Guide and mentor your team to achieve their full potential and success.
• Balance: paid vacation and sick leave with paid maternity and paternity available immediately upon hire
• Real World Experience: You will work hand in hand with our team in learning our business and applying your classroom learning.
• Networking Opportunities: Participate in our corporate intern program and network with other interns at BCBSKS to enhance your learning opportunity.

Compensation

$20.42- $24.30
Non-Exempt Grade 11

• Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The compensation range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive wages that align with the individual's skills, education, experience, and training. The range may vary above or below the stated amounts.

• Research, resolve, and respond to inquiries and correspondence via telephone, written, and email communication. Inquiries may be regarding benefits, eligibility, coverage and plan changes, payments, claims, prior authorizations, appeals, and grievances.
• Resolve customer inquiries and grievances in a timely and accurate manner according to company and regulatory requirements.
• Work with peers, other departments, and leadership to find appropriate solutions to problems.
• May serve as a backup in processing MA member, member representative, or provider appeals and grievances.

• Effective communication skills to resolve complex inquiries and grievances. Must be able to follow Corporate Style Guide and excel at written, as well as verbal communication.
• Ability to interact positively with internal and external customers while demonstrating empathy, adaptability, and listening skills.
• Analytical and problem-solving skills to diagnose problems and recommend effective solutions.
• Ability to listen, talk, type, and perform research simultaneously using various research channels.
• Ability to maintain strict confidentiality in handling data related to job duties.
• Effective time-management skills to respond to customer inquiries promptly.
• Technical skills to effectively use computer programs and troubleshoot simple computer issues independently or with direction.
• Must be comfortable working independently in a structured environment.
• Ability to adhere to a rigid schedule and have regular and predictable attendance.
• Ability to achieve production-based performance goals. Obtain and maintain any departmental or legally required certifications (e.g. CMS or BCBSA requirements).
• Upon completion of training:
  • Working knowledge of Blue Cross and Blue Shield of Kansas’ MA and other relevant customer service systems is required.
  • Detailed knowledge of MA line of business is required.

• High school diploma or equivalent.
• Two years of customer service experience.

• College or continuing education courses in communications and/or medical related fields.
• Two years of navigating multiple computer systems simultaneously.
• Two years of MA or other call center or production-based customer service experience.
• Blue Plan experience.

• Communicate by telephone 95 percent of the workday.
• Use a personal computer in a stationary position at least 95 percent of the workday.

• Base pay is only one component of your competitive Total Rewards package:
  • Incentive pay program (EPIP)
  • Health/Vision/Dental insurance
  • 6 weeks paid parental leave for new mothers and fathers
  • Fertility/Adoption assistance
  • 2 weeks paid caregiver leave
  • 5% 401(k) plan matching
  • Tuition reimbursement
  • Health & fitness benefits, discounts and resources