Please email HR_Talent_AcquisitionTeam@bcbsri.org if you are a candidate seeking a reasonable accommodation for the application and/or interview process.
Schedule: Remote
Compensation: Associate $50,500- $65,700
Intermediate $52,700- $71,200
Jump into the new world of health insurance: At Blue Cross & Blue Shield of Rhode Island (BCBSRI), our business is healthcare. But our focus is on improving lives. Be part of a team that is large enough to make a difference but small enough to be innovative. Work in a rapidly changing field. Take a chance to be creative. Move outside the status quo. Shape new ideas with the power of a national brand behind you.
Join others who know diversity is strength: We appreciate and celebrate everything that makes us unique: age, national origin, citizenship status, perspectives, experiences, physical or mental disability, military status, race, ethnicity, religion, gender, sexual orientation, gender identity and/or expression. Our diversity strengthens us as an organization and helps us better serve an increasingly diverse Rhode Island population.
Why this job matters: Support Commercial members directly and/or via internal referrals from the commercial call centers, by outreaching and responding to members’ inquiries regarding benefits, products, services, resources, network and policies via a variety of methods and digital servicing tools. Identify problems affecting members and providers; notify the appropriate business area(s) to resolve issues and track resolution. Support the organization’s vendor call center team by providing exceptional service, deep program knowledge, and ability to resolve complex member issues to for members and other internal departments.
What you will do:
- Provide service support to Commercial members using a variety of methods including phone calls, email, web chat, written correspondence. Educate members and clearly respond to inquiries concerning products, benefits and eligibility, or billing.
- Act as ‘tier two’ level of support for Tier 1 Care Guides/Call Center Agents. Respond to real time inquiries from Care Guides to help quickly resolve member issues, research and resolve complex member cases passed on from Care Guides, act as a liaison between Care Guides and internal BCBS RI business areas.
- Support for special projects for new service delivery enhancements impacting the commercial market segments, or commercial call center, such as supporting in UAT (User Acceptance Testing), business process improvement, training, MTM inventory reduction, knowledge article reviews and other initiatives, as needed.
- Provide back up to service teams, agent support specialist service teams, as needed.
- Proactively build and maintain positive relationships with members, agents, and internal/external partners. Coordinate with internal and external benefit partners to close issues with access to care.
- Support strategic call center initiatives and projects. Ensure compliance in all aspects of activities with internal policies as well as all regulatory agencies.
- Provide problem resolution to members and agents to support customer satisfaction, NPS and quality scores and metrics.
- Maintain records of customer interactions, record inquiry details and actions, and handle escalated issues within timeliness measures. Refer unresolved issues to appropriate internal departments for additional research.
- Process changes to member accounts and maintain history records. Maintain updated reference materials.
- Ensure compliance in all aspects of activities with internal policies as well as all regulatory agencies.
- Perform other duties as assigned.
What you need to succeed:
- A combination of education and related work experience
- Flexibility to work weekends and shifts that are in the 8 a.m. to 8 p.m. time frame
- Ability to gather and retrieve information in an organized manner
- Excellent communication and customer relationship skills
- Problem solving skills
- Interpersonal skills
- Empathy and patience
- Ability to solve problems
- Computer navigation skills
- Strong written and verbal communications skills
- Time management skills
- Ability to collect and organize data
- Ability to work independently and with a team
- Ability to meet established time and quality standards
- Ability to exercise sound judgment
Extras:
- Three to Five years’ experience in a customer service environment
- Familiarity with health insurance products and services
- Must successfully pass Customer Service Assessments
- Associate’s degree
- Ability to work in a fast-paced call center
- Knowledge of company products
- Knowledge of health insurance or managed care operations
- Bi-lingual skills are helpful, but not required
- Knowledge or experience in working with customers
Location: BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:
- In-office: onsite 5 days per week
- Hybrid: onsite 2-4 days per week
- Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Florida, Georgia, Louisiana, North Carolina, Oklahoma, South Carolina, Texas, Rhode Island, Massachusetts, Connecticut and Virginia.
At Blue Cross & Blue Shield of Rhode Island (BCBSRI), diversity and inclusion are central to our core values and strengthen our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity, affirmative action employer. We provide equal opportunities without regard to race, color, religion, gender, age, national origin, disability, veteran status, sexual orientation, genetic information and gender identity or expression.
The law requires an employer to post notices describing the Federal laws prohibiting job discrimination based on race, color, sex, national origin, religion, age, equal pay, disability, veteran status, sexual orientation, and genetic information and gender identity or expression. Please visit https://www.eeoc.gov/employers/eeo-law-poster to view the "EEO is the Law" poster.
