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    Issue Resolution Specialist - Philadelphia, United States - Independence Blue Cross

    Independence Blue Cross
    Independence Blue Cross Philadelphia, United States

    6 days ago

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    Description

    Our organization is looking for dynamic individuals who love to learn, thrive on innovation, and are open to exploring new ways to achieve our goals. If this describes you, we want to speak with you. You can help us achieve our vision to lead nationally in innovating equitable whole-person health.

    A successful candidate in the Issue Resolution Specialist will exhibit proficiency in taking initiative, attention to detail, communication (verbal and written communication), process orientation, teamwork, and accountability.
    Specific Duties:

    • Ability to apply initial training concepts while demonstrating the ability to learn new concepts.
    • Perform daily investigation of inquiries.
    • Provides regular status reports on all outstanding tasks.
    • Ensure all Inquiries are researched accurately and resolved timely per department guidelines.
    • Monitor each inquiry and follow up regularly and timely as needed.
    • Escalate issues as they arise to management (lead and/or above) for communication to clients or partners.
    • Interact with all internal and external partners across multiple related departments as needed.
    • Identify, track, and report specific trends and issues related to inquiries and system issues.
    • Coordinate with Sr, Lead and/or Supervisor on resolution of inquiries.
    • Acknowledges each piece of mail and responds to written inquiries either by telephone or letter in a professional manner.
    • Effectively resolve all internal requests from diverse areas (via Service Now requests) as directed by Sr and Lead and/or management.
    • May perform other duties as required by management.
    • Ability to work from home, which includes wi-fi capability and a quiet, confidential workspace.
    • Ability to work most holidays, flexibility between hours of 8am-6pm and ability to work overtime as needed including weekend and holidays.
    Qualifications:
    • Knowledge of self-funded health insurance products, ancillary products, (e.g. Dental, Vision, Prescription), the Affordable Care Act, HIPAA laws, and relevant state laws and regulations.
    • Ability to think critically and resolve problems.
    • Strong attention to detail and the ability to excel in a high-paced environment.
    • Proficient with Microsoft Excel, Access, Word, and Outlook.
    • Good listening, written, and verbal communication skills.
    • Ability to multi-task and prioritize activities.
    • Plan to plan experience is a plus.
    Education & Experience:
    • Associate degree in a business-related field or equivalent work experience preferred.
    • Minimum of 3 - 5 years working within self-funded Billing, accounts receivable, claims, enrollment, enrollment reconciliation, or customer service within the Healthcare industry.
    Hybrid

    Independence has implemented a "Hybrid" model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the "Hybrid" model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.
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