Operations Specialist

🔥 0 minutes ago

🏈 Alabama, Arizona, +23 more states – Remote

🏈 Alabama – Remote 🌵 Arizona – Remote ⛰️ Colorado – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🦀 Maryland – Remote 🚗 Michigan – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote ⚔️ Virginia – Remote 🧀 Wisconsin – Remote 🦬 Wyoming – Remote

💵 $41.6k - $66.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

⚙️ Operations

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Blue Cross NC

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1933

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Blue Cross NC is a health insurance provider that offers a range of health plans and services to individuals and groups. The company focuses on delivering quality healthcare coverage and improving health outcomes for its members through innovative health programs and services. Blue Cross NC is committed to enhancing access to affordable healthcare while supporting the health and wellness of the communities it serves.

📋 Description

• Provide cross-functional and cross-team support for operational and healthcare functions supporting Medicare Advantage and ACA populations and other lines of business • Guide members to primary care providers and advise them of available health benefits • Assist members with navigating available benefits • Perform outreach through outbound calls to providers, members, vendors, and other outside contacts • Use effective engagement strategies to encourage members to utilize available benefits and participate in healthy behaviors • Communicate engagement results to leadership and team members • Maintain member confidentiality in accordance with HIPAA guidelines • Coach, educate, and guide members in health program participation and preventive care • Support team members through referrals, mailbox management, work assignment, and documentation • Serve as subject matter expert on work processes, procedures, products, and policies • Provide support, first-level escalation, and research support • Assist with reviewing and updating existing processes and procedures and creating new ones • Provide cross-functional support and departmental expertise to internal stakeholders • Maintain reports and perform tracking and data analysis • Perform other tasks assigned by leadership

🎯 Requirements

• High school diploma or GED • 3+ years of experience in a related field • Experience working with operational healthcare systems is highly preferred • Facets experience navigating member records, eligibility, benefits, and healthcare-related information is highly preferred • Genesys proficiency in call management, queue monitoring, outbound and inbound call activities, wrap-up documentation, and performance metrics is highly preferred • Salesforce experience documenting member interactions, managing cases, tracking outreach activities, and maintaining accurate records is highly preferred • Blue Connect ability to navigate member-facing healthcare tools and resources is highly preferred • Strong working knowledge of Microsoft Excel, including data entry, filtering, sorting, reporting, spreadsheets, and basic data analysis is highly preferred • Authorization to work in the United States

🏖️ Benefits

• The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community • Work-life balance, flexibility, and the autonomy to do great work • Medical, dental, and vision coverage • Numerous health and wellness programs • Parental leave and support • Adoption and surrogacy assistance • Career development programs • Tuition reimbursement for continued education • 401k match including an annual company contribution • Annual Incentive Bonus • Paid Time Off (PTO) • Competitive health benefits and wellness programs