Job Description
Resp & Qualifications
PURPOSE:
Supervise and provides daily direction to multi-functional team members regarding training and development, policies, procedures, and work production quantity and quality. Functional areas may include but not limited to: installation, implementation, client support, client services, client administration, customer service, enrollment and eligibility, claims processing, and call center operations. Reviews and resolves complex service issues not resolvable by subordinates.
ESSENTIAL FUNCTIONS:
- Supervise employee outcomes by training, assigning, scheduling, coaching, and counseling employees; communicating job expectations; planning, monitoring, and appraising job contributions; adhering to policies and procedures.
- Meets operational standards by contributing information to strategic plans and reviews; implementing production, productivity, quality, and customer-service; resolving problems; identifying system improvements.
- Maintains customer service objectives by monitoring daily operations; resolving claims that require manual review or technical support, enrollment or billing related customer issues. Consistently reviews systems and makes necessary adjustments where needed, including resources/staffing. Researches and resolves escalated calls, review and resolve complex claims that have not been resolved by Claims staff.
- Maintains and improves departmental operations by monitoring system performance; identifying and resolving operations problems; supervising process improvement and quality assurance programs; installing upgrades.
- Prepares call center, claims and or enrollment and billing performance reports by collecting, analyzing, and summarizing data and trends.
- Improves call center, claims and or enrollment and billing job knowledge by attending educational workshops.
SUPERVISORY RESPONSIBILITY:
This position manages people.
QUALIFICATIONS:
Education Level: High School Diploma or GED.
Experience: 3 years related professional experience with demonstrated leadership skills.
Must have proficiency in the service, claims or enrollment & billing area.
Preferred Qualifications:
Bachelor's Degree
Knowledge, Skills and Abilities (KSAs)
- Knowledge of call center operations, claims and/or enrollment and billing and work flows.
- Strong presentation skills.
- Highly proficient in Microsoft Office programs.
- Excellent communication skills both written and verbal.
- Ability to plan, review, supervise, and inspect the work of others.
Salary Range: $63,648 - $131,274
Salary Range Disclaimer
The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).
Equal Employment Opportunity
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
Federal Disc/Physical Demand
Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
PHYSICAL DEMANDS:
The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.
Sponsorship in US
Must be eligible to work in the U.S. without Sponsorship.
#LI-AB1
Resp & Qualifications
PURPOSE:
Supervise and provides daily direction to multi-functional team members regarding training and development, policies, procedures, and work production quantity and quality. Functional areas may include but not limited to: installation, implementation, client support, client services, client administration, customer service, enrollment and eligibility, claims processing, and call center operations. Reviews and resolves complex service issues not resolvable by subordinates.
ESSENTIAL FUNCTIONS:
- Supervise employee outcomes by training, assigning, scheduling, coaching, and counseling employees; communicating job expectations; planning, monitoring, and appraising job contributions; adhering to policies and procedures.
- Meets operational standards by contributing information to strategic plans and reviews; implementing production, productivity, quality, and customer-service; resolving problems; identifying system improvements.
- Maintains customer service objectives by monitoring daily operations; resolving claims that require manual review or technical support, enrollment or billing related customer issues. Consistently reviews systems and makes necessary adjustments where needed, including resources/staffing. Researches and resolves escalated calls, review and resolve complex claims that have not been resolved by Claims staff.
- Maintains and improves departmental operations by monitoring system performance; identifying and resolving operations problems; supervising process improvement and quality assurance programs; installing upgrades.
- Prepares call center, claims and or enrollment and billing performance reports by collecting, analyzing, and summarizing data and trends.
- Improves call center, claims and or enrollment and billing job knowledge by attending educational workshops.
SUPERVISORY RESPONSIBILITY:
This position manages people.
QUALIFICATIONS:
Education Level: High School Diploma or GED.
Experience: 3 years related professional experience with demonstrated leadership skills.
Must have proficiency in the service, claims or enrollment & billing area.
Preferred Qualifications:
Bachelor's Degree
Knowledge, Skills and Abilities (KSAs)
- Knowledge of call center operations, claims and/or enrollment and billing and work flows.
- Strong presentation skills.
- Highly proficient in Microsoft Office programs.
- Excellent communication skills both written and verbal.
- Ability to plan, review, supervise, and inspect the work of others.
Salary Range: $63,648 - $131,274
Salary Range Disclaimer
The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).
Equal Employment Opportunity
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
Federal Disc/Physical Demand
Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
PHYSICAL DEMANDS:
The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.
Sponsorship in US
Must be eligible to work in the U.S. without Sponsorship.
#LI-AB1
About CareFirst BlueCross BlueShield
Named by the Ethisphere Institute as one of the “World’s Most Ethical Companies” for 10 consecutive years.
CareFirst. It’s not just our name. It’s our promise. Over 3.5 million people trust us with their healthcare needs, and we take this responsibility seriously.
Our vision for healthcare is clear. Quality care should be easy to afford, easy to use and available to everyone. And what we’re building for you is exactly what we expect for ourselves and those we love.
Every day, we make a meaningful difference in the communities where we live and work. We solve real problems for the people we serve with equal parts empathy and urgency—simplifying the complex, delivering tailored solutions and stepping forward with new ideas.
RECRUITMENT FRAUD NOTICE: CareFirst is aware of an increase in fraudulent job offers being made on behalf of our recruitment team. Legitimate CareFirst recruiters will always contact you from an email address ending in “@carefirst.com” and will never ask for a payment in exchange for a job opportunity or ask you to submit sensitive personal information via email, phone, or text.
COVID-19 VACCINATION NOTICE: As a leading healthcare organization, it is our responsibility to do our part to help end this pandemic and protect the health and well-being of our members, workforce, communities, businesses and partners. Our recruiters continue to fill open positions. Interviews and other processes are being modified to protect the safety of our candidates and team members. Effective November 1, 2021, COVID-19 full vaccination is required for all employees, including those who work remotely today or in the future. CareFirst will comply with all state and local laws regarding vaccine mandates. Medical and religious exemptions will be made where appropriate using our standard vaccine exemption processes.
Independent licensee of BCBSA.
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