customer service representative

business systems analyst

systems analyst

project manager

analyst

Highmark Health

I wanted to like this job, but it became more and more difficult every day. Let me give you an honest look into the position.

The first thing I found odd about this company is that you have to pay for parking. They do not offer any parking to their employees, and parking in the garage across the street is very expensive. You think the pay is good at first, but once you realize that you'll be paying approximately $100 a month just to park, you realize it's not really that good. It's especially not worth the hassle of this position.

There is a 9 week training class before you are released onto the floor. The training was honestly great and I felt like I had truly learned a lot. Unfortunately, let me tell you, as someone who had a perfect average in the training, it is nowhere near enough to do the actual job accurately. Your first day on the floor, you are given a huge list of numbers with zero explanation on when to use them. Seriously, three sheets of paper, front and back with just a ton of numbers. There are so many different types of policies, it's almost impossible to tell when you should actually handle a call or transfer. And then when you do have to transfer, it's an internal number only so you have to explain to the member they have to call in and get transferred every single time just to reach the correct support area. Makes sense, right? All of these people are going to most likely give you negative survey results too, even though it is 100% out of your hands.

The calls you actually do support aren't much better. Everything is so completely convoluted and bogged down with red tape it's almost impossible to get anything done. Even just sending back simple claims for adjustment is a chore because the claims department will send things back for no reason or explanation. A lot of them seem to be outsourced and send back single sentence explanations in broken English. If you ever need help there is a department you can ask if you're on a live call, but outside of that good luck. I've had simple questions and asked my lead if they could stop by my desk, only to be told to instead send them an email that wasn't answered for 2 days.

You are expected to have first call resolution but this is oftentimes simply impossible. I've had calls where the member does not have procedure codes, so I try contacting the provider for them but cannot get through. In this situation your stats are screwed either way-you can tell the member to call back once she has the codes, or you can try calling the provider over and over, driving up your "handle time". You cannot win. I have a hunch the stats are designed the way they are so they don't have to give significant raises. I would rather be told straight up I would not be getting raises, rather than be subject to silly, arbitrary metrics.

Most days are extremely busy and there is literally 0 downtime between calls, not even a few seconds to simply collect yourself. You will handle 45+ calls a day attempting to answer the most convoluted questions. All of the scenarios you go over in training are cookie cutter, best case phone calls. You are in no way prepared for the out of the ordinary calls you will mostly be receiving, and this is from someone who passed the training with a 100% average. It is just not enough and leads are nowhere near as helpful as they're made out to be in training. You are also expected to "follow up" on any open items you have. However, you are only allotted a very small amount of time daily to do this, and if it is a busy day (every single Monday) that time is taken away completely.

With all that being said, there are some positive aspects. The pay is okay for the area, benefits are decent, you get a lot of PTO, there is a free gym. You technically don't get sick days, but you can accumulate approximately 7 occurrences before you are terminated. Your occurrences count against receiving a raise, but believe me even if you're there 365 days a year you won't meet their absurd metrics, unless you are extremely lucky and never talk to a member who is upset about something out of your control. (hint, everything is out of your control. Agents basically exist in order to placate members and prevent supervisor calls, not actually accomplish anything.)

All in all, I don't think this is a completely horrible job, but it certainly isn't good either. You are at least picking up some valuable medical billing/insurance terminology experience. Unfortunately the system itself is very frustrating and you will never have a real sense of accomplishment here. It can be a stepping stone into the medical/healthcare field but not a job I would want for very long. 45+ calls a day is mentally exhausting no matter how positive you try to be, and the almost intentionally confusing way health insurance is designed just makes it that much worse. I would leave work in a daze and spend the time at home mentally preparing myself for the next day.

For the past eight years, I’ve worked for the region’s largest health insurer, Highmark Inc., in various communication roles throughout the company. I’ve been lucky enough to work with the diverse population to which Highmark must communicate to – from its employees, to the Operations staff, to our subsidiary employees and members, to our insurance brokers – learning their different wants and needs along the way. 

I currently work in Distribution Administration on its Distribution Channel Engagement team. We are responsible for all communications to Highmark’s producer population – approximately 230 general agencies with more than 7,500 insurance agents in Pennsylvania and West Virginia. 

From strategic communications, special events and innovation, our team is working with our producers every day to ensure they have all the tools they need to help them build their Highmark books of business. Since I joined the team in June, we moved our newsletter to an online format utilizing Flash animations; we implemented Exact Target to send our emails so we can track the strength of our campaigns; we began hosting trainings for producers, both online and in-person, to provide education on our new Community Blue products in western and central Pennsylvania; and we’re getting ready to implement a new website for producers which will allow for easier quoting and enrollment for our Small Group business. 

Before coming to Distribution Channel Engagement, I worked for Highmark’s Subsidiary Marketing team, assisting with all communication and marketing needs for HM Insurance Group and United Concordia Dental. My experience there allowed me to learn about Highmark’s producer community, gain knowledge around marketing strategy and get involved with member communications. 

The role that led me to Subsidiary Marketing was my position at Industrial Medical Consultants. I was responsible for all marketing and communications, both internal and external, for this 60-employee company. I wrote and designed the quarterly employee newsletter, developed new marketing materials, and planned quarterly educational events for Highmark sales representatives, producers and IMC clients. While I was there, this company was absorbed by Highmark, and my position was moved to the Subsidiary Marketing team.

Prior to IMC, I spent two-and-half years providing internal communication support to Highmark’s single-largest division, Health Plan Operations, which was comprised of 3,500 employees at seven locations in Pennsylvania and West Virginia. I assisted with the launch of the HPO intranet for employees to provide them with timely news and updates about the division, along with a quarterly print newsletter that went to all staff. I also worked on the launch of HPO’s internal closed-circuit television network at four HPO locations, and wrote all content appearing on those channels. 

The position that started my career at Highmark was in Internal Communications. While there, I wrote more than 125 articles for the company’s intranet, supported communication initiatives for its United Way campaign, managed volunteers who distributed our communications to the workforce, and honed my proofreading and editing skills.

Job is basically customer service regarding a client's health insurance benefits, claims, and other concerns depending on what area you are assisting(General, Password/IT, Spending Accounts, Elite.) The call process is generally "scripted" as you access via computer module the benefits/claim details/concern the member is calling on.  Your goal is to assist the member in as little time as possible, document everything relevant and be ready to take the next call within 2 minutes.  If the call doesn't pertain to the area you are assigned within, you transfer the call to the appropriate area.
It takes 6 weeks to train for this position, which would be adequate if the training department were real educators.  They are not and 6 weeks only scratches the basics. 
The computer system modules often don't work well together and during a call if you need to load a module to assist, you hope that it will load up and not affect your overall time.  Sometimes these modules fail to load up or error out.
Floor management may "loan" you out to another call group and fail to mention to you that you are to be taking a call when you transfer it out.  You can receive verbal and written warnings on your record due to these errors.
Floor management shows incredible favoritism on the call floor.  affording opportunities and projects to excel to a select few.  I have seen age and sex discrimination in the office I've worked at and little to stop it.  Floor Management is often moody and express attitudes when you ask questions/concerns, although upper management tell you to ask questions if you can't find an answer.  
Although this is a customer service position, there is a lack of opportunity to service the customer adequately; for example getting enough time to work open cases to complete an investigation or to complete work for a member adequately.  Often at times, they would rather assign your open cases to another representative to finish, where they don't complete the task appropriately, or research your notes to do what needs to be done, and they close your case without communicating to you or confirming what was done.  Often the member will call back upset multiple times.  
The Management seems to prefer quantity over quality on call volume rather than true adequate customer service and that is unacceptable for a health company that promises members first.
Also, your day is "mapped" out regarding your scheduled breaks and lunches.  If you deviate from these scheduled times at all due to an elongated call, it counts against your metrics.
Communication between departments is very poor, and within a department is done in smaller group meetings but also is done inadequately.

• Provided leadership for continuous program growth and enhancement, which included the development of productive partnerships with local, regional, state, and national health care communities.
• Established internal and external relationships at all levels of the organization resulting in long term program development and growth.
• Managed a budget of $6,000,000 and a staff of 5 in 49 counties.
• Improved employee morale, clarified job roles and responsibilities while accomplishing the social mission of the corporation.
• Managed and implemented projects and events:
• Highmark Walk For A Healthy Community , over 100,000 participants; raised in excess of $7,000,000 to support community organizations
• Highmark Fun, Fit, Fabulous Women's Health Conference , over 10,000 participants
• Highmark Partners For A Healthy Community, served hundreds of at risk families through free health, vision and dental services and screenings
Community Health Specialist
Highmark Blue Cross Blue Shield 2001 to 2005
• Provided project management (planning, coordination and implementation) for community programs and events that promoted health and disease prevention strategies for uninsured and underinsured populations.
• Promoted company image and communications through networking with community and business leaders, hospitals, and federally qualified health centers to develop opportunities for access to care for at-risk communities.
• Expanded and strengthened corporate wide volunteer opportunities through strategic programs throughout the community.
A typical day is arriving at 7:00 a.m. and reviewing past projects plans and review of past weeks responsibilities for self and staff.
Usually between 8:00 and 9:00 preparing for any morning meetings which could include my staff, other department meetings, regional meetings and/or meetings with any departments with which we have working relationships . These can include up to 20 to 30 departments within the organization. also on a daily basis. We are constantly meeting with outside community groups, individuals, non profit organizations, corporations, political figures, churches, funders, etc. we are responsible for activities in 49 counties in PA. and have staff in Pittsburgh and Harrisburg which keeps us traveling often throughout the state of PA. The culture is good because our staff of six works as a tightly knit group and is the personification of the word TEAM. As a team we have been exceptionally successful internally and externally ( community ), providing services for the underserved, uninsured, underinsured,
non profit organizations, churches, health centers, etc...........

First and foremost I have never reviewed a job. This is a first for me. I hate this company so much that I actually decided to review it. Hopefully I can save someone from making the mistake of working here: I wouldn't recommend anyone to work here. It's absolutely horrible. Never in my life have I worked for a company that doesn't trust their employees to the point of literally watching their every move. The "command center" will IM you while you are already on the phone with a customer and tell you to go available to take another call. How am I supposed to do that when I'm already on a call?!? Not to mention they will continue to harass you to the point of insanity. Also, sorry but if I have to use the rest room that's just too bad. In a nutshell,  Highmark doesn't care about their employees wellbeing or their customer's. It's really sad and pathetic. I don't know how the health insurance branch of the company even stays afloat.  Happy employees make for happy customers. You can't treat your employees like GARBAGE and expect them to perform. Training is horrible..no one, not even those who have been with the company for years even know what they're doing. Mass confusion constantly, no straight answers and you have no control over accomplishing anything at all. I've never seen the morale of our entire location so low. Everyone is miserable and finding new jobs. Myself included. Highmark took over Blue Cross of NEPA back in 2015. I miss BCNEPA more than you will ever know. Highmark should get their head out of their you know where and take a few pointers from the way they did things. Their methods worked. But no they don't want to hear anything anyone has to say or suggest. They don't care if your child is sick and you have to call off or come in late, heck hey don't care if you're lying half dead in the gutter somewhere or were late because you were held up at gunpoint; you get an occurance. No work life balance at all. They make it clear that you either accept how they do things or leave. Many people chose to leave and I'm also on my way out. It's not worth the aggravation anymore. I could go on and on. I  sincerely hope this review helped at least someone make an educated decision on whether or not to work here. Good luck...

I was in a call center so I would answer member questions and fix problems as the calls came in.

The company tries to have you maintain a good work/life balance. You had a set schedule and were given notice when that was changing. You never had to work weekends and they offered holidays off (including xmas eve and black friday). Most of the people are very friendly and easy to get along with as well.

Other than that, this job is stressful and hard. They expect you to meet stats that at times can seem impossible for new employees. For example, you can only have a certain amount of errors every 4 week period while in training, but there would be times that when you had your review, all the calls weren't pulled so you were told you hadn't made any errors only to find out weeks later that you had a mistake and you made that same mistake on two other calls and each one counts as its own error which could make you get a memo or final warning or lose your job. So not only are you always concerned about your job security in that sense, but then you also have members who are screaming at you and belittling you often.

HR doesn't like to listen to your side either. I had broken a policy not realizing my actions were actually breaking the policy and the HR lady as well as the main manager in the center very rudely just kept asking me how I couldn't have realized and then accused me of actions that would make it seem as I deliberately broke the policy. They made me wait anxiously for an entire week before letting me know they were terminating me b/c of the policy violation when originally I was supposed to know with 3 days and I basically knew from the first conversation, I wasn't going to have a job.

I found it rare to find a customer service rep who would actually say that they like their job. Most people I knew were either looking for other positions or just stayed in their position because they didn't want the hassle of finding a new one.

I would like to start off by saying that i am a current employee and one of the top performers in my unit. This is an honest look at what i do on a daily basis as a CSR at Highmark.  There are often days in which i don't speak to a single other human being face to face.  My day consist of logging into my phone and then being consistently monitored by a group of analysts. For example, it is required that i set my phone into the proper code, then fill out that same code on a paper form simply to get up and use the bathroom.  If i use my "after call" time for more that a minute a "senior" will come to my cubical and tell me to get back on the phones. We are required to use time in between phone calls to handle difficult cases which require advanced research; and that time is typically under 30 seconds (on most days it is back to back phone calls with 0 seconds in between calls).  Myself and other reps in my position routinely use our allotted 20 minutes of break time (for an 8 hour shift) to complete work because it is one of the few times we are not required to be receiving inbound calls.  Management cares little of the concerns of its lower level employees and has recently instituted a script which is mandated to be read verbatim.   CSR's must say, among other things,  "Have i solved your issue today?" even when a grieving family member is calling in to report the death of a loved one.  This leads to painfully awkward social moments.  I would urge anyone looking to apply for this position to not settle and do not buy into the hype that you will be moved up quickly.  In my experience realistically less than 5 percent of CSR's actually stick with the company and eventually move up to better paying positions.  I have been at the company about 2 years and out of my training class of 17 less than half are still employed with Highmark and none have received promotions.

In customer service, almost no one is hired directly. Almost all workers begin as contract workers and they're free to extend your contract until whenever, despite being promised during the interview that the contract is for 6 months. As such, there are no benefits. Sometimes full time employment isn't secure for 18 months to two years. 

There are way to many systems to navigate to answer one question. You have to cross check multiple things, as there are different CRM programs entirely for each department. Changes happen daily. Like massive changes and your coaching is an email that you have to find time to read. 

But the most wild part is how rude everyone here is. I'm not talking about the members as it's state insurance so I expect there to be exasperation from members. I mean the leadership and other departments. Ego is dripping from management and they play unaware when it's addressed. 

The trainers were amazing and the best part of the job, but the actual training material was lacking. There's no time where you actually hear someone take calls when you're in training. Once training is over, you're thrown on the phones. Initially, you're with the trainers. Then, you're with a group of supervisors and managers of various hierarchy who act personally offended when you ask a question. 
 
The turnover for this job is so bad and it's ironic because the job is focused on profit. But if you're customer facing employees are always leaving and the new employees learned different information than previous employees, how are profits supposed to be retained?  When the members who receive the service are frustrated when employees can't find the answer? It's so disheartening to hear people sob on the phones because the insurance, who is supposed to help them, refuses to. 

What is the best part of working at the company?
The best part was the opportunity to strengthen resilience, judgment, and adaptability while working in an environment that often lacked clarity, consistency, and effective cross-functional coordination.

What is the most stressful part about working at the company?
The most stressful part was navigating significant differences in processes, priorities, and decision-making across multiple organizations, often with limited clarity, consistency, or leadership direction.

What is the work environment and culture like at the company?
The work environment was often marked by silos, inconsistent processes, and limited cross-functional alignment. Leadership expectations could be high, but clarity and shared direction were not always present, which made ownership more difficult than it should have been. Although there were strong individuals throughout the organization, the culture itself often felt disconnected and hard to navigate.

What is a typical day like for you at the company?
A typical day involved constant coordination across siloed teams, repeated efforts to gain clarity, and managing work in an environment where expectations were high but alignment was often limited. A significant portion of the day went toward overcoming process gaps, communication issues, and fragmented ownership. Success depended heavily on resilience, follow-through, and the ability to operate without consistent support.

It also involved cross-team coordination, resolving ambiguity, and pushing work forward across groups with different processes and priorities.

Highmark Inc is the primary company ( Great Company!). Highmark Health Options is a subsidiary of Highmark Inc. (Good Company!). BIG TIME DIFFERENCE!!!!. 

Highmark Health owns the contracts, but subs out to Gateway Health Plan. Gateway Health Plan is ship without a rudder or sail. The management team at Gateway Health Plan is constantly struggling to keep Highmark Inc, and Highmark Health Option properly informed. Their claims system has not proper performed since 12.31.17, which has made this job impossible to do with any success. The  Gateway corporate culture in tends to be in a vacuum of the unknown. Highmark Health Options leadership is strong, but is constantly being mis-lead by Gateway Health Plan management as to day to day accountability. 

The C-Suite executives at Gateway (i.e. CEO, COO, CFO, etc..) have all been walked out the door.  In the last two months. 

Leadership within the PI/FWA/SIU department is varied in experience. The Sr. Director is a solid person, and one of the best in the industry! Sr. Director is Honest, Loyal, and dedicated. I really enjoyed working for him, the overall company not so much. 

Gateway HR department is substandard and never vets issues in detail. HR is remote and does not know the people, culture over all. From the day I was onboard till now, Gateway Health Plan is the worst I've seen. 

Overall: If Highmark Health distances itself from Gateway Health Plan, I believe it will improve the overall morale and performance of the company. Unfortunately, Highmark Inc. and Highmark Health Options good name is being hit hard by it association with Gateway Health Plan.

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