Medicare Advantage Support Specialist

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The CSC MA Support Specialist will provide quality assurance, help desk and escalation desk support for Medicare Advantage operations.

"This position is eligible to work onsite, remote, or hybrid (9 or more days a month onsite) 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 April 28, 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

$23.00-27.30

Non-Exempt Grade 12

• 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
  
  

Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas.

Responsibilities

What you'll do

• Assist CXRs with telephone and written customer inquiries. Research and identify solutions, coach in the moment to assist in de-escalating situations and handle escalated situations by resolving customer concerns. Track and trend inquiries received via the help and escalation desks. Directly assist with written and telephone customer inquiries when call center needs necessitate.
• Resolve problems and identify solutions for CXRs, follow appropriate department procedures, document the process and provide clear instructions on how to reach a resolution for future inquiries.
• Monitor live calls, written and email inquiries. Analyze and determine if course of action taken is accurate and within guidelines and departmental procedures. Provide evaluation of outcome and applicable feedback to direct supervision for future coaching opportunities.
• Research and make recommendations of correct information to avoid errors or omissions in our manuals/systems to include, but not limited to: Membership, Claims and Benefit resources and any systems and related research material.
• Same-day turnaround on all open inquiries to support meeting all departmental goals.
• Create and build samples to adequately represent a snapshot of a CXR's skills to be quality checked.
• Utilize survey tracking system to identify action alert and unresolved inquiries, and check the inquiry to determine appropriate resolution.
• Operate in a close team environment. This includes the ability to mentor and serve as quality control or reviewer for other specialists and performing the duties of another team member during their absence. This also extends to assisting training with mentor and shadowing needs when applicable.
• Special projects or tasks as assigned.
• Meet department performance and quality standards of 99% accuracy and comply with corporate compliance program, security policies, standards and guidelines.
  
  

What you need

Knowledge/Skills/Abilities

• Must be able to maintain confidentiality of the job and privacy of those inquiring.
• In depth knowledge of Medicare Advantage contracts to include benefits, claims and enrollment to resolve issues frequently requiring determination of appropriate actions.
• Excellent reasoning, analytical skills, and sound judgment. Must act or think independently to develop a recommendation or resolution directly impacting escalated calls.
• Must demonstrate a strong commitment to providing accurate and quality customer service/interaction while working in a high stress environment and remaining timely, to allow for first call resolution.
• Advanced interpersonal and communication skills.
• Able to work collaboratively and cooperatively as a team member.
• Ability to work within a self-initiated environment with little supervision.
• Exceptional attendance. A successful candidate will be expected to maintain a consistent schedule with minimal unexpected absences.
• Strong computer skills and the ability to learn quickly and effectively utilize company systems and programs.
• Excellent attention to detail, prioritization and time management.
• Must be able to connect coaching elements to the BCBSKS Core Values.
• Must demonstrate a thorough understanding of the MA line of business and the appropriate customer service protocols.
  
  

Education And Experience

• High school diploma or equivalent.
• At least three years customer service experience required.
• Experience with coaching employees is preferred.
• Blue plan experience preferred.
• Medicare Advantage customer service and operations experience preferred.
  
  

Physical Requirements

• Must be able to work at a desk on a computer and/or telephone for up to 8 hours per day.
• Requires being service ready in the telephone queue for escalated calls throughout the day.
  
  

Our Commitment to Diversity, Equity, Inclusion, and Belonging

At Blue Cross and Blue Shield of Kansas, we are committed to fostering a culture of diversity, equity, inclusion, and belonging (DEIB), where mutual respect is at the foundation of our workplace. We provide equal employment opportunities to all individuals, regardless of race, color, religion, belief, sex, pregnancy (including childbirth, lactation, and related medical conditions), national origin, age, physical or mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military or veteran status, family or parental status, or any other characteristic protected by applicable law.

We believe that embracing diversity and authentically promoting inclusion, equity, and belonging among our team members is crucial to our collective success. By intentionally recruiting, developing, and retaining a diverse pool of talent, we cultivate an environment where everyone feels valued, heard, and empowered to contribute. Accommodations are available for applicants with disabilities upon request, ensuring an inclusive and accessible hiring process for all.PandoLogic. Keywords: Quality Control / Quality Assurance Specialist, Location: Topeka, KS - 66612 , PL: 596917527