Health Services Technician-3 years healthcare/Insurance experience
Blue Cross Blue Shield of Arizona is a local, independent Blue Cross Blue Shield Association and a not-for-profit health insurance company headquartered in Phoenix. Founded in 1939, the company has more than 1,800 dedicated employees throughout its Phoenix, Tucson, Chandler and Flagstaff offices. Providing health insurance products, services and networks to more than 1 million Arizonans, Blue Cross Blue Shield of Arizona offers various health plans for individuals, families, and small and large businesses. Blue Cross Blue Shield of Arizona also offers Medicare supplement plans to individuals over age 65.
Blue Cross Blue Shield of Arizona helps to fulfill its mission of improving the quality of life of Arizonans by delivering a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
Internal use only-grade 12-14
Responsible for facilitation of services in a multi-functional Health Services Development department through triage and research for health management cases, precertification/predetermination requests, criteria requests, transition of care issues, letter mailings, and reporting. The role of the Health Services Technician (HST) is to support the clinical Care Manager/ BH UM Clinical Reviewer and is prohibited from conducting evaluations or interpretations of clinical data. The HST position is a non-clinical administrative staff position which does not require licensure or certification. The care managers/BH UM Clinical Reviewers provide support guidance and direction to ensure the HST's have the tools and the resources necessary to support the needs of the case manager/ BH UM Clinical Reviewer.
Required Work Experience
- 3 years of experience in healthcare, health insurance, or related customer service
- High-School Diploma or GED in general field of study
Preferred Work Experience
- 5 years of experience in health care or health insurance field
- Associate's Degree in general field of study
ESSENTIAL job functions AND RESPONSIBILITIES
- Identify, research, process, resolve and respond to customer inquiries and correspondence via telephone, written communication and/or in person.
- Answer a diverse and high volume of health insurance customer calls or correspondence on a daily basis.
- Maintain complete and accurate records per department policy.
- Meet quality, quantity and timeliness standards to achieve individual and departmental performance goals as defined within the department guidelines and required by State, Federal and other accrediting organizations.
- Explain to customers a variety of information concerning the organization’s services, including but not limited to, contract benefits, changes in coverage, eligibility, claims, BCBSAZ programs, provider networks, etc..
- Demonstrate ability to apply plan policies and procedures effectively.
- Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries.
- Research, gather and conduct preliminary analysis of data for department and corporate reporting.
- Maintain all standards in consideration of State, Federal, BCBSAZ and other accreditation requirements.
- Maintain office supplies, equipment, and purchases.
- Ensure confidentiality and control access to sensitive information.
- The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
- Perform all other duties as assigned.
Required Job Skills
- Intermediate skill in use of office equipment including copier, fax machine, scanner, and telephones
- Intermediate PC proficiency
- Intermediate skill in word processing, spreadsheet, and database software
Required Professional Competencies
- Maintain confidentiality and privacy
- Practice interpersonal and active listening to achieve high customer satisfaction and departmental communication standards
- Interpret and translate policies, procedures, programs and guidelines
- Capable of investigative and analytical research
- Navigate, gather, input and maintain data records in multiple system applications
- Follow and accept instruction and direction
- Establish and maintain working relationships in a collaborative team environment
Required Leadership Experience and Competencies
Preferred Job Skills
- Intermediate understanding of medical terminology
- Intermediate comprehension of anatomy and medical practices
Preferred Professional Competencies
- Knowledge of a wide range of subjects pertaining to the organization's service and operations
- Analytical knowledge necessary to generate reports based on available data and then make decisions based on reported data
Preferred Leadership Experience and Competencies
- Ability to build synergy and interdependence with a diverse team, in a changing environment
BCBSAZ does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.
Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.
Imagine doing life-changing work and helping more than one million Arizonans live healthier and longer lives. That’s the kind of satisfaction you’ll find when you work here. Our exceptional teams in Phoenix, Tucson, Chandler, and Flagstaff have been transforming healthcare for more than 80 years. Explore what's possible with a career at Blue Cross® BlueShield® of Arizona