Part Time IFP PPO Customer Care Representative Job

Looking for a chance to do meaningful work that touches millions? Come join the hardest working, nonprofit health plan in California and help us shape the future of health care. Blue Shield of California's Mission is to ensure all Californians have access to high-quality care at an affordable price. Blue Shield is focused on improving health care delivery by working closely with providers and making it more accessible, affordable and customer-centric. Being a mission-driven organization means we do much more than serve our 4 million members: we were the first health plan in the nation to limit our annual net income to 2 percent of revenue and return the difference to our customers and the community, and since 2005 we have contributed more than $325 million to the Blue Shield of California Foundation to improve community health and end domestic violence. We also believe that a healthier California begins with our employees, so we provide them with resources to develop and maintain a healthy lifestyle through our award-winning wellness program, Wellvolution.

We're hiring smart thinkers and doers who want to work for a leader and innovator in the challenging, ever-changing healthcare space. Come and help us make health care better for everyone.

Description:

Successfully exceed Associate level responsibilities. In addition, Successfully completes tier 2 training which covers some of the following: Handles escalated calls; may de-escalate calls Responds to member benefits in writing Peer to peer coaching /training Performs inventory reduction, routine to mid-level, (i.e. member inquiries, may adjust claims, responds to emails, etc.) May expedite, research, and resolve complex issues Consistently performs established performance metrics, such as quality, production; average handling time (AHT) and calls per hour (CPH) Works with minimal supervision

Qualifications:

Successfully meets requirements of nesting audit Have strong customer service experience (especially phones) and a proven ability to meet performance standards Strong organizational skills Ability to work independently Ability to mentor others Ability to interpret the various health plans and any documentation associated with them Minimum Experience Level Typically 1-2 years of related experience successfully demonstrating increasingly higher level work