Customer Service Advocate

Job Description

Embodies the service vision, objectives, and values of the organization by acting as a service expert for Blue Cross NC customers, employer groups and providers.
Strengthens the Blue Cross NC brand by developing, managing, and expanding customer relationships at service levels that meet and exceed customer expectation
Accurately, promptly, and professionally respond to members, employer groups, providers and other stakeholders. Strives to obtain customer satisfaction and first contact resolution while meeting the demand of members through all channels including phone and chat.

What You'll Do

• Engage with key stakeholders such as providers, billing, and/or case managers to resolve customer concerns and educate customer on their benefits, claims and eligibility
• Provide customer education by conducting training sessions at employer sites and facilitating online sessions
• Support ongoing complex customer inquiries such as those with serious health conditions and complex claims/benefit issues
• Screen members to determine case management needs while using additional administrative or clinical resources as needed
• Adjust simple/routine claims as needed (for Provider only)
• Provide multi omni-channel inbound and outbound inquiry support
• Interact with member/provider using probing and creative problem-solving techniques for diagnosis and issue resolution
• Assist customers in navigating our online and mobile tools while encouraging and guiding them towards becoming self-sufficient in using them
• Guide customers to make the best health care decisions by educating them on topics such as understanding benefit plan selections, maximizing the value of their health plan benefits, and choosing a quality care provider
• Educate customers on their next best options and provide education so that the member can make the best decision to for their health
• Be a driver for new ideas and innovation while being an advocate for continuous process improvement
• Engage with local, state and federal government entities and plan participants regarding our products, services and policies
• Serve as subject matter expert or mentor to team members for non-routine inquiries
• Leverage analytical skills to query, analyze and interpret data to address customer and business needs

What You Have

• High school diploma or GED
• 3+ years of experience in related field.

Bonus Points

• Proven, hands-on Facets experience
• Strong customer/member service orientation.

• Knowledge of benefits and eligibility.

• Strong claims knowledge, including the ability to review a claim, connect the claim to applicable benefits

• IPP experience is preferred but not required

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$41,600.00 - $66,561.00

Skills

Active Listening, Client Issue Resolution, Customer Care, Customer Education, Customer Engagement, Customer Satisfaction, Customer Service, Customer Service Operations, Key Customer Management, People Management

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JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com.

About Us

About Us

It's an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care − in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians.

Blue Cross NC is a fully taxed, not-for-profit company headquartered in Durham, North Carolina. We serve more than 4.3 million members, and we employ more than 5,000 people across the country who are passionate about making health care better for all.

Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives.

Authorization to Work in the United States

We use E-verify to confirm authorization to work in the United States. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify Overview for English or Visión General de E-Verify for Español.

Request Accommodations

Blue Cross NC provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application, hiring process, or have technical issues that prevent you from completing your application please notify HR at HR.Staffing@bcbsnc.com.

For most roles, you can choose where to work - fully remote in one of the states listed below, in the office, or a hybrid of the two:

Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming

Much more than a paycheck

The total value of working at Blue Cross NC goes far beyond your paycheck. We offer benefits and perks that help you thrive, such as competitive health benefits, bonus plans based on performance, 401(k) with employer match, paid time off (plus two well-being days), and a variety of career development and wellness programs.