Technical Specialist Claims

BCBSM•River Park, FL

4d•$24 - $36•Remote

About The Position

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us. This vacancy is the result of the previous employee's promotion into another role within the organization. This position serves as a resource to claims staff in resolving complex issues. Through this process, this position provides training and mentoring along with coordination, development, and delivery of claims specific training for claims operations staff. This position is responsible for serving as a subject matter expert (SME) internally and for other Blue Plans.

Requirements

4+ years of related experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
Excellent interpersonal skills.
Strong presentation skills.
Ability to explain complex procedures, products, and concepts.
Thorough understanding of company computer applications.
Demonstrates conflict resolution skills.
Well-developed oral and written communication skills.
Demonstrates planning, prioritization and organizational skills.
Demonstrates confident and independent decision-making skills.
Demonstrated flexibility to adapt to changes in procedures and job assignments.
Demonstrated ability to work independently and in a team environment.
High school diploma (or equivalency) and legal authorization to work in the U.S.

Nice To Haves

Prior insurance or health care experience.
Prior experience interacting with customers.
Knowledge of operating systems specific to claim processing.

Responsibilities

Serves as primary resource for staff in interpretation of contracts, system, procedures, or policies.
Provides guidance to staff while assisting in resolution of difficult and/or sensitive issues.
Provides written and verbal feedback to supervisors regarding individual employee performance.
Provides supplemental and on-the-job training to new and existing staff in an individual or group setting.
Assists the Claims Business Training Unit in the development of training content, lesson plans, job aides and training materials.
Identifies and develops training opportunities with claims leadership.
Audits individuals work and provides feedback to employees while keeping leadership appraised of the progress of each individual.
Analyzes and provides recommendations for possible changes in workflow procedures or situations.
Responds to internal customers and other Blue Plans inquiries.
Completes assigned special projects that require research, analysis, and documentation.
Provides back-up support to leadership.
Serve as subject matter expert for other areas by providing mentoring, best practices, development, etc.
Willingness to take on complex projects.
Determine problem cause, develop, and implement solutions and provide quality communication on outcome.