Customer Services Concierge Support, Intermediate
Blue Shield of California · Redding, California, United States
Your Role
The Shared Advantage team is a multi-functional team providing services and support for third-party administrators (TPA), including claims processing, high dollar review, written correspondence, client services concierge phone support, e-mail and correspondence,. The Claim Processor, Intermediate will report to the Shared Advantage supervisor. In this role you will learn to process and adjust simple and complex claims, apply return files, and respond to written correspondence.
Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
Your Work
In this role, you will:
- Be experienced in back-end processing; proficient in resolving complex edits using available documents/job aids with minimum direction
- Experience front-end processing and difficult adjustments
- Be given special processing assignments; coordinate with other departments for resolution if needed
- Understand fundamentals of end-to-end (life of a clam) claims processing
- Perform established performance metrics
- Compose correspondence to answer claims/provider inquiries in writing
- Support Blue Shield's mission of being a great place to do meaningful work
- Drive and support a positive team culture
Your Knowledge and Experience
- Requires High School Diploma or GED or 1 year of additional relevant experience in lieu of diploma
- Requires 1-3 years prior relevant experience
- Ability to problem-solve and resolve complex claims issues
- Maintain professionalism and a positive attitude
- Be dependable, reliable, responsible and can work independently
- Have excellent interpersonal communication skills and work well within a team
Hybrid Virtual Work
This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.