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Healthcare / Healthcare
Premera Blue Cross Hiring for Member Customer Service Representative III at Remote Full Time
Full Job Description
Join Our Team: Do Meaningful Work and Improve People’s Lives
Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.
To better serve our customers, we’re creating a culture that promotes employee growth, collaborative innovation, and inspired leadership.
Forbes ranked Premera among America’s 2022 Best Midsize Employers
because we are committed to creating an environment where employees can do their best work and where best-in-class talent comes, stays, and thrives!
COVID-19 Vaccination Policy:
To learn more about our COVID-19 vaccination and accommodation requirements, please visit our Careers landing page.
Premera is committed to making healthcare work better, and it all starts with the Customer Service Representative. To help us continue to provide the best support for our customers, Premera is hiring additional Customer Service Representatives based out of Eastern Washington, Idaho, Oregon, Montana, Texas, and Arizona. If you have 18 months of customer service experience this can be your opportunity to start your career!
As a Customer Service Representative, you play an essential role in ensuring that the customers we serve are provided with a first call resolution.
Our customers often have questions that they are not able to resolve themselves and you help resolve those questions by providing information and education.
You will execute a wide variety of tasks including managing inbound and outbound calls, conducting research on claim status, and investigating requests. Your hard work and commitment to provide excellent service will ensure that our customers feel they have received the level of support they expect. Occasionally, issues will require additional support and you will escalate them appropriately. You will also document all your work to help ensure accuracy, identify trends, and improve processes.
The Customer Service Representative III provides inbound and/or outbound customer service support ensuring delivery of accurate, complete, and timely information pertaining to member policies and coverage, thoroughly documenting all calls. Conducts research to provide claims status, as well as investigates routine requests and escalates all call issues as required. Understands complexity of different lines of business and/or call types. Customer Service Reps III provide high level service to both members and providers or other BlueCard plans and perform complex project work. Sr. Member Service Reps provide high level service to members in multiple geographic locations, covering individual and group plans for all types of insurance coverage and perform complex project work.
What you will love:
- Set schedule with consistency – Monday through Friday, 8-hour shift between 5 a.m. and 8 p.m. Pacific Time.
- Career progression opportunities.
- Twelve weeks of paid virtual training (100% attendance required).
- Work from home, full time (40-hour week).
- Upon successful graduation of the 12-week training class, Premera will provide a one-time pre-tax allotment of $500 (minus taxes) towards home office furniture.
- Generous benefits package that starts on Day 1 including health, dental, vision, PTO, and incredible retirement packages.
What you will do:
- Accountable for inbound and/or outbound phone-based customer service for customers/members and providers providing first call and/or email resolution to complex call types and/or multiple lines of business. Provide caller education, through clear and accurate exchange of information.
- Provide support to other Customer Service Representatives II (CSRs) as required including Assist Queue or floor support.
- Address complex problems and issues for multiple lines of business and/or call types. Conduct complex research to resolve problems and issues.
- Follow-up, resolve and document issues of each call.
- Follow up on pended items and route incoming paperwork in a timely manner to correct departments for completion.
- Route inquiries needing further investigation to the appropriate department or vendor.
- Work with highly sensitive information while maintaining Personal Protected Information (PPI) requirements.
- Other duties as assigned.
- Dedicated to respond to member calls regarding benefits, billing, eligibility, enrollment, appeals, prior authorization, and prescription questions.
- Interact with all members via phone, email or other electronic methods, and in person to meet their needs. May call external agencies or vendors on behalf of the member to resolve inquiries.
- As a dedicated Member Service Representative, resolve all issues for members which may include conducting research and escalating issues as needed.
What you will bring:
- Eighteen (18) months previous customer service experience (Required).
- Completion of formal Premera customer service training program within four (4) months of hire.
- Two (2) years of college level courses or equivalent experience.
- Phone related customer service experience.
- Healthcare, benefits, call center, claims processing or Facets experience.
- Bilingual proficiency in a particular language (English/Spanish) with the ability to articulate messages and information clearly and accurately.
Apply today for immediate consideration!
What we offer
- Medical, vision and dental coverage
- Life and disability insurance
- Retirement programs (401K employer match and pension plan)
- Wellness incentives, onsite services, a discount program and more
- Tuition assistance for undergraduate and graduate degrees
- Generous Paid Time Off to reenergize
- Free parking
Equal employment opportunity/affirmative action:
Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.
If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at [email protected] or via phone at 425-918-4785.
The pay for this role will vary based on a range of factors including, but not limited to, a candidate’s geographic location, market conditions, and specific skills and experience.
National Salary Range:
$41,600.00 – $62,400.00
National Plus Salary Range:
$47,000.00 – $70,500.00
- National Plus salary range is used in higher cost of labor markets including Western Washington and Alaska.