Part-Time Member Services Representative

Details
Type: Current Job Openings

Requirements

High school diploma or equivalent. Company will provide job related training. Prior customer service experience is preferred.

General Purpose

Part-time, 20-29 hours a week.  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

  • Works toward quality initiatives.
  • Resolves provider inquiries and complaints via written and/or telephonic communication in a timely and accurate manner.
  • Records all inquiries into the computer system for a permanent record.
  • Initiates adjustments for services not properly processed by forwarding to appropriate area.
  • 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.

Other Duties & Responsibilities

  • Other duties as assigned.
  • As needed, assists with coverage of telephone monitor, switchboard and reception desk.
Supervisory Duties

None

Job Qualifications

Knowledge, Skill & Ability
  • Must possess good telephone skills.
  • Must be able to comprehend and explain insurance contract language.
  • Must be able to comprehend provider contract language.
  • Demonstrates good organizational and time management skills.
  • Strong communication skills
  • Ability to handle demanding and/or stressful situations
Education, Licensure, or Formal Training

High school diploma or equivalent.  Company will provide job related training.

Experience

Prior customer service experience is preferred.

Equipment & Environment

Material & Equipment Directly Used

Standard office equipment.

Working Environment / Physical Activities

Works in a member call center and will be required to remain seated, wearing telephone headset for extended periods of time.

Access to Protected Health Information (PHI)

Access to PHI is broad due to job function requirement of responding to customer inquiries relative to claims payments, eligibility, contract benefits and other inquiries.

Notes & Other Information

Position summary shown may not include ALL of the necessary knowledge, skill, and ability requirements.

Note: Position summary shown may not include ALL of the necessary knowledge, skill, and ability requirements.

Blue Cross Blue Shield of Wyoming
EOE M/F/Vet/Disabled Employer
E-Verify

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