The position is accountable to resolve customer service inquiries from Internal and External customers in a timely manner. This position is also responsible for accurately documenting each inquiry into system using the format designed for the specified area. The incumbent is responsible for taking appropriate action to resolve caller’s inquiry. In addition, this position generates daily reports and is responsible for other duties assigned by the supervisor. The incumbent must educate the caller beyond their initial question to fully take advantage of benefits, prevent adverse impact and resolve on first contact. This position can progress to Customer Service Expert (5014) based on competencies.
Job Duties & Responsibilities
Professionally handle incoming telephone calls from Internal and External customers
Take appropriate action to resolve the question or complaint timely and accurately
Enter telephone inquiry report of contact into customer service intake screen
Maintain telephone performance goals established by the specified division
Maintain acceptable MTM quality accuracy based on division guidelines
Manage personal route list daily
Provide the same high quality service to “walk-in” inquiries that is provided for telephone inquiries
Work with all departments in the division or company to resolve customer service inquiry issues
Attend available training sessions to further enhance skills
The ability to talk while keying is essential
Ensure timely and accurate completion of daily/weekly telephone reports
Stay up-to-date regarding online resources, such as Online Help, BlueAlert, Medical Policy, and all other electronic resource changes when applicable
Keep abreast of changing divisional guidelines and government regulations.
Research and determine cause of problem and effect of resolution
Effectively educate caller on available web tools
Perform miscellaneous projects as assigned
This position requires flexibility due to rotations in schedules and requires adherence to assigned schedules
Work overtime as required
High School Diploma or equivalent required
Claims processing and/or customer service experience preferred
If current employee with the company, must meet minimum performance expectations
Microsoft Office products knowledge desired
Effective oral communication and interpersonal skills
Good written communication skills
Sound decision-making and problem-solving skills
Exceptional organizational and time management skills
Must be able to key 5500 keystrokes per hour with less then 10% error rate (if applicable)
Testing will be required.
Job Specific Requirements:
Number of Openings Available:
BCBST is an Equal Opportunity employer (EEO), and all employees and applicants will be entitled to equal employment opportunities when employment decisions are made. BCBST will take affirmative action to recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or membership in a historically under-represented group.
BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.
Tobacco-Free Hiring Statement
To further our mission of peace of mind through better health, effective 2017, BlueCross BlueShield of Tennessee and its subsidiaries no longer hire individuals who use tobacco or nicotine products in any form in Tennessee and where state law permits. A tobacco-free hiring practice is part of an effort to combat serious diseases, as well as to promote health and wellness for our employees and our community. All offers of employment will be contingent upon passing a tobacco/nicotine test. An individual whose test result is positive for tobacco/nicotine will be disqualified from employment and the job offer will be withdrawn. Individuals who fail the tobacco/nicotine screening will be permitted to reapply for employment after 6 months, if tobacco/nicotine-free.
Resources to help individuals discontinue the use of tobacco/nicotine products include smokefree.gov or 1-800-QUIT-NOW.