Provider Customer Service Professional I

Job Description

Overview

Regence Customer Service Professional I

Tacoma, WA

Class Start Date: May 4, 2020

Minimum starting pay: $15.95; Maximum starting pay $16.95 DOE

We ask you have High Speed Internet and a private location at home to potentially train/work from home

Role Closes: March 27, 2020

Responsibilities & Requirements

Due to growth of our company and department, we are looking to expand our team. Bring your excellent customer service skills to the Provider Customer Service Professional I role! As a Provider Customer Service Professional I, you will provide information, education and assistance to providers, other health-care professionals, or other provider representatives on recorded phone lines regarding benefits, claims and eligibility. Provide excellent and caring services to all providers. In addition you will:

• Be the primary contact between the corporation and providers.
• Quickly and accurately assess provider inquiries and requirements.
• Identify errors promptly and determine what corrective steps may be taken to resolve errors.
• Determine benefit payments, maximum allowable fees, co-pays, and deductibles from appropriate contracts.
• Explain benefits, rules of eligibility and claims payment procedures, pre-authorizations, medical review and referrals, and grievance/appeal procedures to providers to ensure that benefits, policies and procedures are understood.

Key Qualifications and Experience

• Provider Customer Service Professional I would have a high school diploma or equivalent and 6 months customer service call center experience or 6 months customer service experience such as insurance, retail, banking, restaurant, hospital medical office or other experience with extensive customer service contact or equivalent combination or education and experience.
• Proficient PC skills and prior experience in a PC environment
• Demonstrated Knowledge of medical terminology and coding preferred
• Ability to apply mathematical concepts and calculations
• Ability to communicate effectively orally and in writing with understanding and ability to apply correct punctuation, spelling, grammar and proof-reading skills.
• Demonstrated ability of strong customer-service skills, including courteous telephone etiquette
• Ability to make decisions and exercise good judgment in a complex and rapidly changing environment
• Ability to adapt to a fast-paced environment and learn, retain, and interpret new or evolving information, procedures, and policies and communicate them effectively
• Ability to work under stress and pressure and respond to inquiries with tact, diplomacy and patience
• Ability to work in a team environment
• Ability to exercise discretion on sensitive and confidential matters
• Demonstrate initiative in researching and resolving benefit, and eligibility issues

Customer Service Professionals work Monday through Friday between from 7am – 5pm and potential flexible work from home opportunity after 9 months. To show our dedication to employee satisfaction, our generous benefit package starts on your first day. Our leadership team is committed to creating a supportive, fun, and empowering environment where you’ll gain skills and experience in an ever-changing health care industry and have a positive effect on your local community.

Note: Please check your email (including spam and junk mail folders) during the process for important status updates and information.

About Us

Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. We offer a competitive salary and a generous benefits package. We are an equal opportunity employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A drug screen and background check is required.

Regence is 2.2 million members, here for our families, co-workers and neighbors, helping each other be and stay healthy and provide support in time of need. We've been here for members more than 100 years. Regence is a nonprofit health care company offering individual and group medical, dental, vision and life insurance, Medicare and other government programs as well as pharmacy benefit management. We are the largest health insurer in the Northwest/Intermountain Region, serving members as Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (in Washington). Each plan is an independent licensee of the Blue Cross and Blue Shield Association.

If you’re seeking a career that affects change in the health care system, consider joining our team at Cambia Health Solutions. We advocate for transforming the health care system by making health care more affordable and accessible, increasing consumers’ engagement in their health care decisions, and offering a diverse range of products and services that promote the health and well-being of our members. Cambia's portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access and free-standing health and wellness solutions.