Location: Monroe,LA, USA
We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.
Residency in or relocation to Louisiana is preferred for all positions.
**Grade 3**
**Are you searching for your next career opportunity? Do you have a passion for providing excellent customer service? Would you like the opportunity to work from home? We are actively recruiting for a Call Center Class based out of our Monroe office! Apply today and join us in supporting our mission to improve the health and lives of Louisianans.**
**What does Member Service Representative do?**
+ They serve as first point of contact for the organization. The MSR handles incoming calls from members and providers answering questions and offers guidance via the telephone with individuals in a prompt, courteous, and professional manner.
**What does training look like?**
+ During the first 3 months of employment, you will be in our blended training program where you will come onsite for some training at our Monroe office and attend the remainder virtually. Our training is progressive and builds on concepts learned each day to prepare you to be comfortable and confident in your role. The schedule will be 8:00am-5:00pm Monday-Friday during training.
**What is a must have?**
+ Customer Service experience or equivalent
+ Must be available to report to Monroe location for the onsite components of new hire training and connection days monthly.
+ Flexibility to work weekly rotating shifts consisting of: 8-5, 9-6, 11-8 which will primarily be remote with some days required onsite and ability to work rotating weekends as well as some holidays.
+ Commitment to a 12 week training program
+ Hardwired internet connection with speeds greater than 5MB upload and 10MB download if working from home
**Whats in it for you?**
+ A comprehensive new hire training program designed to help set you up for success
+ Opportunity to work from home with limited in-office requirements
+ Competitive pay starting at $17.20 per hour
+ Excellent benefits package including medical, dental, vision, life insurance, an amazing Wellness Program, 401k contributions in addition to paid time off, and paid holidays starting Day 1!
+ Professional development opportunities and access to grow your career
+ Volunteer Opportunities
+ Inclusion Networks to share and connect with your coworkers
**POSITION PURPOSE**
The Member Service Representative is responsible for utilizing in-depth knowledge of company products over multiple lines of business to provide both telephonic and in-person service and support to customers within their specialized line of business in a timely, professional, and hospitable manner.
**NATURE AND SCOPE**
+ This role does not manage people
+ This role reports Departmental Leadership
**QUALIFICATIONS**
**Education**
+ High School Diploma or equivalent is required.
**Work Experience**
+ Prior experience as listed below required:
+ 1 year of customer service or medical office experience required
+ A certificate in medical office assistant or medical coding can be used in lieu of the one year of experience
+ Previous experience in a call center is preferred
**Skills and Abilities** **.**
+ Excellent phone skills.
+ Ability to type a minimum of 35-50 WPM with accuracy.
+ Ability to talk and type simultaneously.
+ Proficient in Microsoft Office Suite (Excel, Word, Power Point, etc.)
+ Ability to preform simple calculations.
+ Must be highly organized and efficient with strong attention to detail.
+ Excellent verbal and written communication skills.
+ Ability to interact effectively with all levels of staff
+ Ability to perform consistently at a high level with a heavy call volume in a fast-paced call center setting
+ Ability to maintain a positive, empathetic, and professional attitude.
**Licenses and Certifications**
+ None Required
**ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS**
+ Assists members with questions, concerns, and complaints, acknowledging and resolving all issues promptly and professionally both in person and over the phone.
+ Provides explanation of benefits and claims status results.
+ Process payments received over the phone
+ Assist with provider inquiries.
+ Documents specifics of each call in the call tracking module.
+ Determine and classify nature of call by components of grievances, appeals, and/or coverage determinations and handle appropriately.
+ Promotes Exchange, Short-Term, and/or Medicare products and assist with enrollment process
+ Responsible for checking and responding to voicemails and email requests.
+ Researches prescription drug, copay, and bill issues.
+ Complete workflow assignments in OnBase and FaxCom daily.
+ Follows-up on V-Tasks to ensure timely response to customers inquiries.
+ Completes weekly breakdown of member/provider/broker/inquiry calls for auditing purposes.
+ Reviews weekly audits provided by the Member Service Auditor.
+ Reconciles monthly Language Line Usage with the invoice.
+ Appeal claims on behalf of members and providers, and provide follow-up once resolution has been determined
+ Assist Production Enrollment and Marketing as needed.
**Additional Accountabilities and Essential Functions**
_The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions_
+ Perform other job-related duties as assigned, within your scope of responsibilities.
+ Job duties are performed in a normal and clean office environment with normal noise levels.
+ Work is predominately done while standing or sitting.
+ The ability to comprehend, document, calculate, visualize, and analyze are required.
**An Equal Opportunity Employer**
**All BCBSLA EMPLOYEES please apply through Workday Careers.**
PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)
**Additional Information**
Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the My Applications section in the Candidate Home section of your Workday account.
If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact ...@bcbsla.com for assistance.
In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.
_Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner._
_Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results._
**JOB CATEGORY:** **Insurance**