What are the responsibilities and job description for the Correspondence Phone Support, Intermediate position at Blue Shield of California?
Job Summary
As a Senior Markets Customer Service Representative, you will be responsible for upholding our mission of providing exceptional customer service to our members. Our members look to you to help them navigate healthcare, providing empathy and advocacy.
Key Responsibilities:
- Deliver an effortless customer experience by providing accurate and timely responses to member inquiries.
- Review and analyze member claims for accuracy, as well as educate members on how benefits are applied.
- Participate in quality and efficiency workgroups to continuously improve quality and member satisfaction.
- Verify member eligibility for outreach or care gap programs and connect members to programs or services when appropriate.
- Provide prescription formulary coverage information and utilization management requirements using web-posted printed formulary.
- Perform prescription claim overrides and provide status of prior authorization requests.
Requirements:
- Ability to work a scheduled 8-hour shift, including 2 scheduled breaks and a lunch period.
- Availability to work Saturday and/or Sunday, and occasional holidays as part of your regularly scheduled shift.
- Comfortable using a computer with 2 display monitors to navigate multiple screens for information.
- Proficient in using Excel spreadsheets to calculate member premiums for health insurance.
- Ability to multi-task using a computer while talking to members and entering information into their online record.
- Basic knowledge of Microsoft Suite systems and ability to use applications on a computer proficiently.
- Private work location at residence free from distractions and within 25 feet of Wi-Fi modem.
- Bilingual proficiency in Spanish, Korean, Mandarin Chinese, Tagalog, or Vietnamese (demonstrated by successful completion of oral language proficiency test).
Work-from-Home Policy:
After completing training, agents will be assigned a 40-hour shift/schedule between the hours of 8am to 8pm, 7 days a week, and will be able to work from home according to our work-from-home policy.
Training:
Mandatory training will be conducted remotely, requiring attendance and completion of paid training sessions for 8 hours per day, totaling 40 hours per week.
