Client Services Pharmacy Support Analyst

Job not on LinkedIn

🔥 0 minutes ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

💵 $19 - $35 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

📞 Support Engineer

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Capital Blue Cross

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1938

🏥 Healthcare

💼 Consulting

🛡️ Insurance

Healthcare • Consulting • Insurance

Capital Blue Cross is a health insurance company that offers a range of health plans for individuals, families, and employers. They serve customers in Central Pennsylvania and the Lehigh Valley, focusing on providing health coverage services such as Medicare plans, student health plans, and resources for managing medical care. Capital Blue Cross positions itself as a partner in health, emphasizing support for members' overall wellness and preventive health measures.

📋 Description

• Research and review customer inquiries related to vendor lines of business • Interpret applicable policies and procedures and determine appropriate actions • Obtain benefits, enrollment, and claims information using PCs, manuals, online references, Imaging, and other systems • Resolve routine and complex inquiries involving benefits, claims, billing, enrollment, legal requests, Medicare Secondary Payer, COBRA, reinstatements, conversions, refunds, and related issues • Conduct job-related instructional sessions as requested • Respond to customers via telephone, correspondence, on-site interactions, fax, Secure IT, email, and personal interviews • Monitor vendor inquiries through system-generated reports for timely and accurate resolution • Provide instructions to appropriate plan areas for issue resolution • Contact internal and external entities to obtain information and initiate action • Update Facets inquiries, Sales Force cases, and Work Desk records and maintain progress notes • Report trends and processing problems to management • Support Marketing personnel and brokers by researching and communicating customer information • Participate in marketing activities such as open enrollment and on-site visits • Complete ongoing training and learn new skills • Recognize, document, and report customer-service trends to the supervisor • Maintain conduct consistent with organizational values

🎯 Requirements

• 3 years customer service or correspondence experience, or experience/training in a writing-intensive role • High School degree or equivalent • Customer interaction experience preferred • Ability to communicate effectively and professionally verbally and in writing • Ability to understand and interpret detailed policies and procedures • Understanding of HIPAA requirements for protecting Protected Health Information • Ability to work independently and adapt to changing assignments and work environments • Analytical, organizational, and problem-solving skills • Proficiency operating a PC and associated software and office equipment • Competency in Windows, Outlook, Word, Internet Explorer, Excel, PowerPoint, SharePoint, and Sales Force • Above average reading, writing, and arithmetic skills • Knowledge of Medicare Advantage, Medicare Part D, Medicare Supplemental Programs, Dental, Vision, Chiropractic, Prescription Drug, Benefits Management, and Disease Management • Knowledge of PBM and Facets health plan administration processing systems • Knowledge of benefits administration, billing, claims processing, ERISA, Act 68, BCBSA MTM, PPACA, HIPAA, and Account Administration regulations • Ability to work 37.5 hours per week, including flexible schedules, nights, and weekends based on business needs

🏖️ Benefits

• Medical, Dental & Vision coverage • Retirement Plan • Paid Time Off • Holidays • Volunteer time off • Incentive Plan • Tuition Reimbursement • Flexible schedules • Training and continuing education • Professional and personal growth opportunities • Community volunteering opportunities