Location: Hartford,CT, USA
You likely know us as an insurance company, but that's just a portion of what we do. Hundreds of thousands of North Dakotans trust us to provide them with personalized service and unmatched access to care. It's a mission we take seriously.We also work with entities throughout the state to challenge the cost and complexity of health care in North Dakota. This uncompromising goal requires caring, innovative people who are ready and willing to help create a new level of health and well-being in North Dakota and beyond.Work environmentThis opportunity is eligible for remote work or a hybrid work arrangement. We empower our employees to find a work style that is best for them. Learn more at Life at Blue | BCBSND.This position is eligible for internal and external applications.Pay informationFLSA Category: Non-Exempt-HourlyA day in the lifeThe Claims Service Advocate is responsible for reviewing moderately complex health insurance claims and provides customer service to members, providers, and/or customers by telephone, computers, and/or written inquiry. This position determines how to apply benefits and whether to return, deny, or pay claims following organizational policies and procedures.Your responsibilities will includeUtilizes various systems and process guidelines to review, process, and adjudicate moderately complex claims, ensuring quality and timeliness standards are met.Reviews moderately complex claim inquiries by analyzing, interpreting, and researching the request to determine appropriate action. Initiates any requests to update member information, when necessary.Responds to incoming reports, medical records, and other related documents to make claim determinations for additional processing.Provides information, guidance, and education to members and customers in complex and escalated situations while working in close partnership with other internal departments to ensure customer satisfaction.Conducts research on behalf of members, providers, and customers, which may include the review of documents, statements, and information supplied by other outside agencies.What you need to succeedHigh School Diploma or GED with at least 3 years of experience in customer service or related experience.Resolves problems, makes suggestions, and implements process improvements.Pays close attention to the details of all work and strives for a high level of accuracy.Meets or exceeds customer expectations.Possesses strong communication skills, both written and verbal.Equivalent combination of education, experience, or training determined to be acceptable by Human Resources may be substituted, unless regulated by contract or program standards.Benefits and perksWellness incentives including well-being lifestyle spending accounts, employee assistance program, and employee discounts.Encouraged paid time off including paid holidays and flexible holidays to use as you wish.16 hours of paid volunteer time with a $200 donation to a charity of your choice upon completion of all volunteer hours.Employee recognition, community initiative events, and yearly company outings.Workplace flexibility offering different options for working arrangements and the freedom to make time for important commitments.Our core benefits include health, dental, vision, and life insurance, short-term and long-term disability, and paid parental leave.Equal opportunity employmentEqual Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities, as well as Sexual Orientation or Gender Identity.This job posting will be closed 10/1/2024 at 8:00 a.m. (CT). No further applications will be considered.Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities.#J-18808-Ljbffr