Provider Services Representative

Customer SupportCustomer SupportFull TimeRemoteTeam 1,001-5,000Since 1938H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

14 days ago

Salary

Not specified

No structured requirement data.

Job Description

The Provider Service Representatives are the front-line team at Capital BlueCross and are responsible for handling all provider inquiries through multiple channels such as phone, web, provider portal (e.g. Availity), electronic, plan to plan chat, and/or face-to-face. Manage multiple channel interactions professionally, efficiently and with excellent communication skills. Effectively present and discuss the products and services to external and internal providers with integrity and understanding. Focus on provider retention through first call resolution of concerns. Establish and maintain positive relationships with providers on behalf of the company. Ensure all providers’ needs are completely met, timely, without elevation if possible. If business needs permit, support the efforts of sales representatives by conducting onsite and/or community-based educational meetings. Emphasize quality, productivity, adherence, and handle time without jeopardizing the company's provider relations. Complete ongoing training to stay abreast of products, services, and policy changes. Improve quality of work daily by learning and employing new skills or adapting previous processes. Recognize, document, and alert supervisors of trends in provider calls. Conduct self in a manner consistent with the values of the organization.

Job Requirements

  • 1 year customer service experience.
  • Experience with provider interaction preferred, but not required.
  • Must have a High School Diploma or GED.
  • Bi-lingual (Spanish) a plus.
  • Demonstrates ability to understand and interpret detailed policies and procedures.
  • Ability to maintain privacy of Protected Health Information as required by the Health Insurance Portability and Accountability Act.
  • Demonstrates ability to work independently and react appropriately to changing job assignments.
  • Demonstrates ability to communicate effectively and professionally both verbally and in writing.
  • Ability to use telephone equipment systems such as Interactive Voice Response and Automated Call Distribution.
  • Familiarity with the utilization of a PC and various software such as Microsoft Office Suite.

Benefits

  • Comprehensive benefits package including Medical, Dental & Vision coverage.
  • Retirement Plan.
  • Generous time off including Paid Time Off, Holidays, and Volunteer time off.
  • An Incentive Plan.
  • Tuition Reimbursement.

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