Member Service Representative

🔥 13 minutes ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

💵 $16 - $31 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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

• Provide efficient, courteous, professional service to members, providers, group administrators, brokers, Plan personnel, and the general public • Respond to inquiries received by telephone, fax, written correspondence, email, internet messenger, and personal interviews • Address enrollment, billing, benefits, and claims inquiries for various coverage types • Research and analyze customer inquiries using policies, procedures, PC systems, manuals, and Image • Resolve routine and moderately complex benefits, claims, billing, enrollment, COBRA, Medicare Secondary Payor, and related issues • Provide clear instructions to appropriate Plan areas for issue resolution • Contact internal and external entities to obtain information and initiate necessary action • Respond verbally or in writing with accurate and timely information • Monitor inquiries for timely and accurate resolution and customer satisfaction • Update Facets or Inquiry Control System records to track inquiry actions and status • Report inquiry trends to management • Support Marketing personnel and brokers by researching and communicating customer information • Participate in marketing activities such as health fairs, seminars, open enrollment, and on-site visits

🎯 Requirements

• High school diploma or G.E.D. • 1 year customer service experience • Ability to understand and interpret detailed policies and procedures and apply them to various situations • Thorough understanding of Capital Blue Cross’s responsibility to maintain privacy of Protected Health Information as required by HIPAA • Ability to work independently, remain flexible, and react appropriately to changing job assignments and work environments • Effective and professional verbal and written communication skills • Analytical, organizational, and problem-solving skills • Ability to use telephone equipment systems such as Interactive Voice Response and Automated Call Distribution • Familiarity with a PC and Microsoft Office Suite • Ability to perform sedentary work involving sitting, talking, hearing, keying, repetitive motions, and close visual inspection of documents and monitors

🏖️ Benefits

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