Summary
 

Oversees a team of client services representatives responsible for member/provider services.

Description
 

Location:

This position is full-time (40 hours/week) Monday-Friday in a typical office environment. Employees are required to have flexibility work any our 8-hour shift scheduled during hours of 8am - 6pm due to contractual obligations. Training will be Monday – Friday 8:00 AM 5:00 PM for approximately 6-8 weeks. This role is located on site at 4101 Percival Road, Columbia SC.

Sponsorship: This position is not eligible for sponsorship now or in the future.

What You’ll Do:

• Ensures prompt and accurate response to calls, e-mail, web, handwritten inquiries. Supervises telephone coverage from 8:00am-8:00pm Monday through Friday between April and September. Reviews member inquiries on the weekends to meet CMS 24-hour response requirements. Supervises telephone coverage from 8:00am-8:00pm 7 days of the week from October through March except for Thanksgiving Day and Christmas Day.
• Ensures all departmental standards are being met. Responsible for ensuring business and customer needs are met systematically and correctly. Assist management with interviews, selection, training, performance, productivity, and development of staff.
• Monitors calls, service, and workload. Tracks any service complaints and analyzes problems in order to provide solutions or develop proper training of staff. Completes monthly scorecards. Oversees outbound call campaigns related to member retention, member disputes, member welcome calls, and delinquency. Oversees the maintaining of VIP and frequent caller list.
• Represents department on projects and process improvements. Provides assistance and training to other operational areas of the company as needed.

To Qualify for This Position, You’ll Need the Following:

• Required Education: Bachelor’s degree
• Degree Equivalency: 4 years job related work experience OR Associate’s and 2 years job related work experience.
• Required Specialized Training:  Overall understanding of CMS enrollment, disenrollment policies; must understand CMS Part D Drug Manual and processing guidelines to respond to pharmacy-related questions; must understand ITS rule and regulations ; must understand ever-changing supplemental benefits such as: dental, vision, fitness, over-the-counter, hearing, and telehealth; must be knowledgeable of medical management processes to include: investigating gap closures, at-home diabetic testing, and at-home colon screenings.
• Required Work Experience: 1-year claims, customer service, and/or call center experience.
  Required Skills and Abilities: Strong oral and written communication skills. Strong decision making, analytical, problem-solving, and time management skills. Ability to handle confidential or sensitive information with discretion.
  Required Software and Other Tools: Microsoft Office
   

We Prefer the Following:

• Preferred Education: Bachelor's degree in business administration, healthcare, or related field.
• Preferred Degree Equivalency: 4 years of job-related work experience.
• Preferred Work Experience:
• Medicare Supplement and Medicare advantage policies.
• Experience with SCHIP.
• 1 year of leadership experience including scheduling or coordinating work of others, developing work procedures, training, and/or leading group project initiatives.
• Preferred Skills and Abilities: Ability to persuade, negotiate, or influence. Strong organizational skills. Strong spelling, punctuation, and grammar skills.

Our comprehensive benefits package includes the following:

We offer our employees great benefits and rewards.  You will be eligible to participate in the benefits the first of the month following 28 days of employment.  

• Subsidized health plans, dental and vision coverage
• 401K retirement savings plan with company match
• Life Insurance
• Paid Time Off (PTO)
• On-site cafeterias and fitness centers in major locations
• Wellness program and healthy lifestyle premium discount
• Tuition assistance
• Service recognition
• Employee Assistance
• Discounts to movies, theaters, zoos, theme parks and more

What We can Do for You:

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

What to Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.

Management will conduct interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the required qualification

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email [email protected] or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information.

Some states have required notifications. Here's more information.