Member Advocate Representative (CSR/Healthcare experience preferred)
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.
CAPS/GEN - 10-14
Purpose of the job
This is a highly specialized customer service position with an emphasis on excellence, privacy, compliance, and versatility within the health insurance industry. The position will identify, research, process, resolve, and respond to staff and customer inquiries and correspondence via telephone, written communication, and/or in person.
Required Work Experience
1 years of experience in claims examination, health insurance, customer service, call center, medical office, or other healthcare-related field
High-School Diploma or GED in general field of study
Within 45 days of hire in member concierge, Mi Consejero Azul, or areas supporting sales, employee must hold an active, current, and unrestricted AZ Department of Insurance Health Insurance License
Preferred Work Experience
2 year(s) of experience in claim processing, customer service, call center, health insurance, medical office, or other healthcare-related field
Associate's Degree in general field of study
A valid Arizona driver license with an acceptable driving record if travel is required (e.g. regional employees)
Active, current, and unrestricted AZ Department of Insurance Health Insurance License for member concierge, Mi Consejero Azul, or areas supporting sales
ESSENTIAL job functions AND RESPONSIBILITIES
Oversee day-to-day member engagement outbound call activities which can include outbound calls to members based on campaign message, inbound calls from members about campaign message.
Understand member engagement campaign objectives, materials sent to members and action items requested of the member to better service and engage with the member.
Collaborate with management and team members to meet objectives of the outbound campaign and advocate for member health and coverage needs.
Proactively engage other areas to follow up on unique member needs based on outbound calls made to members.
Leverage motivational and engagement techniques to reach goals of campaign and member needs
Accurately capture business outcomes from outbound and inbound call activities to properly report on results of outbound call campaigns.
Assist member with any questions, issues and concerns regardless of the campaign message delivered.
Identify, research, process, resolve, and respond to staff and customer inquiries and correspondence via telephone, written communication, and/or in person.
Meet quality, quantity, and timeliness standards to achieve individual and department performance goals as defined within the department guidelines.
Explain to customers a variety of information concerning the organization’s services, including but not limited to, wellness opportunities, how to best leverage their health plan, how to set up AutoPay, PCP needs, BCBSAZ programs, provider networks, etc.
Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries.
Document and record facts related to inquiries and correspondence by updating BCBSAZ files and system.
Demonstrate and maintain current working knowledge of the required BCBSAZ systems, procedures, forms, and manuals.
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 computers, MicroSoft Office suite, internet browsers, teleconferencing platforms, telephone, and other relevant technology
Advanced bilingual (Spanish/English) skill in verbal communication - - Spanish representative only
Required Professional Competencies
Every interaction is handled with the utmost care, consideration, and passion for the members we serve.
Maintain confidentiality and privacy
Practice interpersonal and active listening to achieve high customer satisfaction
Compose and dictate a variety of business correspondence
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 knowledge of insurance claim coding
Intermediate understanding of dental and 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
Preferred Leadership Experience and Competencies
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