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Correspondence Phone Support, Intermediate

Company: Blue Shield of CA
Location: Rancho Cordova
Posted on: September 7, 2020

Job Description:

At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. Were excited to share Blue Shield of California has received awards and recognition for LGBT diversity, quality improvement, most influential women in corporate America, Bay Areas top companies in volunteering & giving, and one of the worlds most ethical companies. Here at Blue Shield of California, were striving to make a positive change across our industry and the communities we live in Join us!

Correspondence/Phone Support - Responds to and resolves various customer inquiries via telephone and correspondence, and resolves claims problems within established production and quality standards. Answers incoming calls and written requests for information from members or providers promptly and accurately. Composes routine and non-routine correspondence to answer member inquiries that require a written response. Coordinates with other departments to ensure timely and appropriate responses. Expedites and resolves complex issues and initiates claim adjustments. Educates others on the Blue Shield product, providing accurate information and updates to policies and procedures, improving overall customer satisfaction. Capable of effectively navigating through multiple platforms or applications to efficiently locate information and complete processing tasks.

Essential Responsibilities:

* Able to perform lower level responsibilities.

* Handles escalated calls, may de-escalate calls.

* Responds to producer inquiries in writing.

* Peer to peer coaching /training.

* Performs inventory reduction, routine to mid-level, (i.e. producer inquiries, may adjust claims, responds to emails, etc.).

* Expedite, research, and resolve complex issues.

* Consistently performs established performance metrics including but not limited to voice of the customer survey results, quality and production.

* Other duties as assigned.

Correspondence/Phone Support - Responds to and resolves various customer inquiries via telephone and correspondence, and resolves claims problems within established production and quality standards. Answers incoming calls and written requests for information from members or providers promptly and accurately. Composes routine and non-routine correspondence to answer member inquiries that require a written response. Coordinates with other departments to ensure timely and appropriate responses. Expedites and resolves complex issues and initiates claim adjustments. Educates others on the Blue Shield product, providing accurate information and updates to policies and procedures, improving overall customer satisfaction. Capable of effectively navigating through multiple platforms or applications to efficiently locate information and complete processing tasks.

Essential Responsibilities:

* Able to perform lower level responsibilities.

* Handles escalated calls, may de-escalate calls.

* Responds to producer inquiries in writing.

* Peer to peer coaching /training.

* Performs inventory reduction, routine to mid-level, (i.e. producer inquiries, may adjust claims, responds to emails, etc.).

* Expedite, research, and resolve complex issues.

* Consistently performs established performance metrics including but not limited to voice of the customer survey results, quality and production.

* Other duties as assigned.

* Requires basic job knowledge of systems and procedures obtained through prior work experience or education.

* Typically, requires minimum of 3 years of experience.

* May require vocational or technical education in addition to prior work experience.

Preferred Qualifications:

* Bilingual (Spanish)

* Requires basic job knowledge of systems and procedures obtained through prior work experience or education.

* Typically, requires minimum of 3 years of experience.

* May require vocational or technical education in addition to prior work experience.

Preferred Qualifications:

* Bilingual (Spanish)

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

Keywords: Blue Shield of CA, Rancho Cordova , Correspondence Phone Support, Intermediate, Other , Rancho Cordova, California

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