Blue Shield of California Hiring for Producer Customer Care Representative Job at Lodi, CA Full Time

Blue Shield of California’s mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that truly serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our comprehensive approach to diversity, equity, and inclusion combines a focus on our people, processes, and systems with a deep commitment to promoting social justice and health equity through our products, business practices, and presence as a corporate citizen.

Blue Shield has received awards and recognition for being a certified Great Place to Work, best place to work for LGBTQ equality, leading disability employer, one of the best companies for women to advance, Bay Area’s top companies in volunteering & giving, and one of the world’s most ethical companies. Here at Blue Shield of California, we are striving to make a positive change across our industry and the communities we live in – join us!

Your Role

As a Producer Customer Care Representative (CCR), you are in charge of upholding our mission of providing service worthy of our family and friends. The Producer Customer Care Representative reports directly to the Operations Supervisor and is part of the Customer Experience organization. In this role you are responsible for effectively managing and resolving Provider inquiries in an inbound call center environment. Representatives are the first point of contact for Provider inquiries that range from members eligibility, benefits, provider information, monthly premium billing, broker commissions and more. Our priority is to provide a broker experience of the upmost care and compassion by conveying empathy and resolving all issues as quickly and effortlessly as possible.

***Anticipated start date: April-May 2022

Your Work

In this role, you will:

• Comprehensive resolution of broker related inquiries including commissions, broker supplies, appointment of brokers etc.
• Resolves incoming calls concerning broker, members eligibility, benefits, provider information, monthly premium billing, and broker needs.
• Quote benefits and verify eligibility.
• Compose routine and non-routine correspondence to answer customer inquiries that require a written response.
• Coordinate with other departments to ensure timely and appropriate responses.
• Make changes to primary care physician upon request.
• Reviews and analyzes member claims for accuracy as well as member education on how benefits are applied.
• Participate in quality and efficiency workgroups to continuously improve quality member/customer satisfaction as requested.
• Enhanced knowledge of medical terminology.
• Perform established performance metrics including but not limited to voice of the customer survey results, quality, and production.