Job Description
Act as a solution-focused, service advisor for BCBSNC customers, employer groups and providers, with the ability to successfully service more complex healthcare insurance needs.
Demonstrates proficiency with added product, functional, and/or technical knowledge to better provide consistent, reliable and customized stakeholder service interactions in a highly efficient and effective manner. Strengthen the BCBSNC brand by developing, managing and expanding customer relationships at service levels that meet and exceed customer expectations.
START DATE:
5/24/2024 Successfully utilizes added knowledge of product types, functional and/or technical skills to provide solution focused service to our customers on more complex insurance questions and issues.
Successfully able to understand and communicate complex concepts to members, providers and colleagues in verbal and written form.
Display leadership through all actions both internally and externally.
Support and be committed to the mission, vision and values of the company by delivering seamless, energetic and innovative service solutions to increase stakeholder satisfaction and retain customers.
Utilize probing and creative problem solving as well as critical thinking and the ability to analyze more complex and ambigu
us information to resolve customer inquiries on first contact.
Document corrective measures and detailed customer information reelevate to each customer contact and provide instructions as needed to internal business areas to ensure prompt resolution and response to customer inquiries
Ensures final disposition of each inquiry in a timely manner. Identify and obtain information and records from customers, members, providers and/or employer groups to correct/update information, claims and membership records when necessary.
Recognize patterns of inconsistent and/or inaccurate claims filing practices among customers and providers, educate customers and providers on acceptable BCBSNC practices and policies.
Perform phone/email outreach to BCBSNC vendors and business partners to resolve service issues. Identify, understand and anticipate customers’ unexpressed needs and concerns in a caring manner.
Work collaboratively with business partners to further optimize customer, employer group and provider relations by identifying opportunities to promote stakeholder programs. Promote programs, making sound decisions to apply the most appropriate “stakeholder centric” course of action to respond to needs. Educate and encourage customers on use of alternative delivery channels (i.e. self service, web).
Identify and communicate process, product or systems improvement opportunities to improve the overall stakeholder experience. Interface with local, state and federal governmental entities and plan participants regarding BCBSNC products, services and policies.
Customer Service Representative
