Job Description

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.

 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.  

  • 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.
 

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.

Skills / Requirements

  1. Required Work Experience
  1. Required Education
  • High-School Diploma or GED in general field of study
  1. Preferred Work Experience
    • 5 year(s) of experience in health care or health insurance field
  1. Preferred Education
    • Associate's Degree in general field of study
  1. Required Job Skills
  1. 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
 

Application Instructions

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