Job Description

Resolve complex customer inquiries received by phone or though written correspondence. Provide excellent service to customers. Coach and mentor junior staff members.

Responsibilities:

• Receive escalated customer inquiries and provide second level resolution by initiating or continuing investigation process, utilizing available resources and accurately documenting customer inquiry and actions taken in accordance with departmental quality guidelines.
• Follow up on unresolved high priority/complex issues to ensure they are brought to conclusion in a timely manner.
• Serve as a liaison for key internal and external operational contacts to ensure that an optimal level of service is provided to customers.
• May assist in monitoring and managing team-s call volume and inventory including tracking and trending key customer service issues and reporting them to management.
• Deliver an excellent customer service experience while meeting quality and production standards.
• Perform other relevant tasks as assigned by management.

Education/Experience:

• High School Diploma/GED required
• 18 months+ call center/customer service experience required
• Health insurance industry experience required.

Knowledge:

• Medical terminology and medical billing coding required
• Knowledge of multiple claims systems preferred

Skills and Abilities:

• Excellent Customer Service skills
• Ability to work in a high pressure, fast pace environment
• Keyboarding proficiency
• PC proficiency
• Strong verbal and written communication
• Interpersonal skills (i.e. active listening)
• Strong investigative and analytical skills
• Ability to multitask
• Ability to manage and diffuse irate calls
• Time management skills
• Flexibility and adaptability

*The employer may require an employee to pass a test(s) as part of determining whether the applicant meets the minimum qualifications for the job.

Salary Range:

This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:

• Comprehensive health benefits (Medical/Dental/Vision)

• Retirement Plans

• Generous PTO

• Incentive Plans

• Wellness Programs

• Paid Volunteer Time Off

• Tuition Reimbursement

Disclaimer:

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.

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