About Blue Cross Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We’re committed to reinventing health care to improve health for our members and the community. We hope you'll join us.
This position is responsible for serving as a liaison, advocate and subject matter expert for an assigned client. The incumbent serves as first contact for the client and coordinates resolution of complex non-routine issues such as adverse benefit determinations, complex claims or ITS related inquires.
- Advocates for client through research of internal systems, processes, policies and other Blue Cross departments to identify root cause and determine appropriate resolution option(s).
- Serves as first contact and technical expert for internal/external client; provides occasional on-site meetings as requested.
- Develops and maintains strong internal and external client relationships.
- Provides on-going education, via written or verbal responses, to client to clarify our position regarding company policies and procedures.
- Reviews reports and identifies trends in issues impacting client satisfaction.
- Works with other parts of the organization to identify root cause and recommend process and procedural changes to improve customer service.
- Serves as subject matter expert for internal employees and leadership regarding client(s).
- Acts as an internal support for service staff through examination complex issues, supporting first contact resolution and de-escalation of volatile client issues.
- Analyzes, develops and implements service center workflow and procedure changes.
- Provides supplemental and on-the-job training to new and existing Service Representatives/Health Guides in individual or group settings.
- Assigned other projects or duties as appropriate to meet business needs.
Required Skills and Experiences:
- 2+ years of related experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
- Knowledge of health insurance regulations and/or provider agreements.
- Excellent verbal and written communication skills with ability to express complex concepts in simple terms.
- Demonstrated skills in conflict resolution.
- Demonstrated skills as an empathetic and compassionate communicator.
- Demonstrated strong research, analytical, problem solving, and decision-making skills.
- Demonstrated ability to handle midsize or large employer groups. Ability to work independently and in a team environment.
- Demonstrated ability in making timely service oriented decisions that align with corporate procedures and protocol.
- Demonstrated ability to establish and maintain positive interpersonal relationships with customers.
- Demonstrated ability to enhance or develop new skills in response to changing expectations.
- Ability to prioritize multiple projects at once.
Make A Difference Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, gender expression, or any other legally protected characteristic.
Reasonable Accommodation for Job Seekers with a Disability: If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to talent.acquisition@bluecrossmn.com.
All roles require a high school diploma (or equivalency) and legal authorization to work in the U.S.
Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
