Issue Resolution Specialist - Blue Cross and Blue Shield Association : Job Details

Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our mission to enhance the health and well-being of the people and communities we serve.

Job Summary:

A successful candidate in this role will exhibit proficiency in taking initiative, attention to detail, communication (verbal and written communication), process orientation, teamwork and accountability.

Specific Duties:

* Ability to apply initial training concepts while demonstrating the ability to learn new concepts.

* Perform daily investigation of inquiries.

* Provides regular status reports on all outstanding tasks.

* Ensure all Inquiries are researched accurately and resolved timely per department guidelines.

* Monitor each inquiry and follow up regularly and timely as needed.

* Escalate issues as they arise to management (lead and/or above) for communication to clients or partners.

* Interact with all internal and external partners across multiple related departments as needed.

* Identify, track, and report specific trends and issues related to inquiries and system issues.

* Coordinate with Sr, Lead and/or Supervisor on resolution of inquiries.

* Acknowledges each piece of mail and responds to written inquiries either by telephone or letter in a professional manner.

* Effectively resolve all internal requests from diverse areas (via Service Now requests) as directed by Sr and Lead and/or management.

* May perform other duties as required by management.

* Ability to work from home, which includes wi-fi capability and a quiet, confidential workspace.

* Ability to work most holidays, flexibility between hours of 8am-6pm and ability to work overtime as needed including weekend and holidays.

Qualifications

* Knowledge of self-funded health insurance products, Ancillary products, (e.g. Dental, Vision, Prescription), the Affordable Care Act, HIPAA laws, and relevant state laws and regulations.

* Ability to think critically and resolve problems.

* Strong attention to detail and the ability to excel in a high paced environment.

* Proficient with Microsoft Excel, Access, Word, and Outlook.

* Good listening, written and verbal communication skills.

* Ability to multitask and prioritize activities.

* Plan to plan experience is a plus

Education & Experience

* Associate Degree in a Business-related field or equivalent work experience preferred.

* Minimum of 3 - 5 years working within Self-Funded Billing, or Accounts receivable, or Claims, or Enrollment, or Enrollment reconciliation, or Customer Service within the Healthcare industry.

Hybrid of Choice:

Independence has implemented a Hybrid model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the Hybrid model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.

Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.