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Cheyenne

    Member Services Representative Level 1 - Cheyenne, United States - Blue Cross Blue Shield of Wyoming

    Blue Cross Blue Shield of Wyoming
    Blue Cross Blue Shield of Wyoming Cheyenne, United States

    4 weeks ago

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    Description
    Job Description Summary:
    Handles inquiries by telephone and/or email from providers in a customer service center. Troubleshoots and resolves provider complaints. Ensures that responses to inquiries are completed timely and according to established service and quality standards.

    Job Description:

    JOB SUMMARY

    Handles inquiries by telephone and/or email from providers in a customer service center. Troubleshoots and resolves provider complaints. Ensures that responses to inquiries are completed timely and according to established service and quality standards.

    ESSENTIAL DUTIES & RESPONSIBILITIES
    • Resolves provider inquiries and complaints via telephonic communication in a timely and accurate manner.
    • Records all inquiries into the computer system for a permanent record.
    • Works toward quality initiatives.
    • Utilizes and understands computer screens to provide accurate answers.
    • Works closely with co-workers when necessary to research answers to inquiries.
    • Elevates issues to next level as appropriate.
    • Strives to resolve provider concerns in a single interaction.
    • Meets all production, quality and adherence standards. Attends all required training sessions.
    • Initiates adjustments for services not properly processed by forwarding to appropriate area.
    • Other duties as assigned.
    NON-ESSENTIAL DUTIES & RESPONSIBILITIES

    As needed: handles telephone monitor, switchboard and front desk.

    APPLICABLE KNOWLEDGE, SKILLS, & ABILITIES (KSA)
    • Must possess good telephone skills
    • Must be able to comprehend and explain BCBS contract language
    • Must be able to comprehend provider contract language.
    • Demonstrates good organizational and time management skills with strong communication skills
    • Is able to deal with demanding, stressful situations
    • Prior Customer Service experience is preferred
    QUALIFICATIONS
    • High school degree or equivalent. Company will provide job related training pertaining to company unique information.
    PHYSICAL/MENTAL DEMANDS & WORK ENVIRONMENT

    While performing the essential duties of this position, an employee will typically experience:
    • Standing, walking, and sitting.
    • Lifting and/or moving up to 10 pounds; occasionally lifting and/or move up to 25 pounds short distances.
    • Usage of close vision, distance vision, and ability to adjust focus.
    • Manipulation of keyboards, keypads, and calculators.
    • Placing and answering telephone calls.
    • Focused task tracking and follow-through.
    • Some interpersonal tension in problem-solving/resolution interactions.
    • Speaking/presenting to internal and external audiences of diverse sizes.
    • Work environment noise level that is usually moderate.
    • Open office environment with few, if any, loud sounds, or ongoing auditory distractions.
    • Some deadline related stress.
    • As needed evening and weekend hours on a periodic basis.
    • Minimal travel, typically in-state.
    To perform successfully in this position, an individual must be able to perform essential duties satisfactorily as well as possess education/experience, knowledge, skill, and abilities (KSA) as listed in representative fashion; reasonable accommodations may be made to enable individuals with limitations/disabilities to perform the essential functions of this position. The essential duties and KSA listed are not all inclusive, but representative. Other duties may be assigned.

    Blue Cross Blue Shield of Wyoming is an EOE, M/F/Vet/Disabled employer. Blue Cross Blue Shield of Wyoming uses
    E-Verify to confirm employment eligibility.

    Equal Opportunity is the Law

    EEO is the Law Supplement

    IER Right to Work

    FMLA

    E-Verify

    Pay Transparency
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