Sr. Call Center Service Assoc-1

Horizon Blue Cross Blue Shield of New Jersey•Newark, NJ

About The Position

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds. About the Role Resolve complex customer inquiries received by phone or though written correspondence. Provide excellent service to customers. Coach and mentor junior staff members.

Requirements

High School Diploma/GED required
18 months+ call center/customer service experience required
Health insurance industry experience required.
Medical terminology and medical billing coding required
Excellent Customer Service skills
Ability to work in a high pressure, fast pace environment
Keyboarding proficiency
PC proficiency
Strong verbal and written communication
Interpersonal skills (i.e. active listening)
Strong investigative and analytical skills
Ability to multitask
Ability to manage and diffuse irate calls
Time management skills
Flexibility and adaptability

Nice To Haves

Knowledge of multiple claims systems preferred

Responsibilities

Receive escalated customer inquiries and provide second level resolution by initiating or continuing investigation process, utilizing available resources and accurately documenting customer inquiry and actions taken in accordance with departmental quality guidelines.
Follow up on unresolved high priority/complex issues to ensure they are brought to conclusion in a timely manner.
Serve as a liaison for key internal and external operational contacts to ensure that an optimal level of service is provided to customers.
May assist in monitoring and managing team-s call volume and inventory including tracking and trending key customer service issues and reporting them to management.
Deliver an excellent customer service experience while meeting quality and production standards.
Perform other relevant tasks as assigned by management.