CUSTOMER / PROVIDER SERVICE REP I

CUSTOMER / PROVIDER SERVICE REP I

Responsibilities: Customer/Provider Service Representatives service members, accounts, brokers or medial providers by analyzing, interpreting and resolving inquiries and complaints pertaining to Blue Cross and Blue Shield benefit coverage (across all product lines), membership status, claims status and payments. Inquiries may be received via phone, letter, internet, VRU or customer walk-ins and must be resolved in a manner that satisfies the customer and supports corporate objectives. Reviews and calculates claims payments and initiates adjustments as necessary.

This position is accountable for achieving pre-established goals of quality, productivity and performance in order to effectively meet the service needs of the department and the corporation to assure maintenance of established customer/provider goals and expectations.


Equal Employment Opportunity: We are an Equal Employment Opportunity / Affirmative Action Employer

Other Information: SOME POSITIONS MAY REQUIRE FLEXIBLE WORK HOURS. ALL POSITIONS ARE LOCATED AT OUR AUGUSTINE CUT-OFF (Suburban Wilmington) LOCATION.

Hire Range Disclaimer: Please note that the "Hire Range" posted is only a suggested hire range. Actual salary will be based on relevant job experience and work history. Candidates may be hired as either a Level I or Level II based on qualifications and experience.

BCBSD offers a competitive salary and benefits package and a professional work environment.

Closing Date: PLEASE APPLY Before 9/7/06

Where to Apply: Must Apply on line @ www.bcbsde.com

Blue Cross Blue Shield of Delaware and CareFirst, Inc., are independent licensees of the Blue Cross and Blue Shield Association.
REQUIREMENTS
Qualifications:
Required:
High school diploma or equivalent plus 1 – 2 years of customer service experience.

Abilities/Skills:

- Detail-oriented, effective written and verbal communications skill
- Effective team and interpersonal skills; a professional manner for telephone and personal contact with customers/providers is needed for handling difficult or sensitive situations.
- Previous keying or PC experience to include MS Word and Excel.
- Ability to work independently with creativity and resourcefulness.
- Demonstrated success in handling large volumes of work
- Complex problem-solving skills. Organizational and time management skills.
- Analytical and decision-making skills.

Preferred:
Call Center and/or healthcare or health insurance industry experience highly preferred.
1 to 2 years of college in Business or other related education preferred.