BlueCross BlueShield of Western New York

About BlueCross BlueShield of Western New York


Job Category:

Business Development


United States

Postal Code:


Approximate Salary:

Not Specified

Position Type:

Full Time

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Account Specialist

Posted: 08/9/2018

Auto req ID 1839BR Company BlueCross BlueShield of WNY About Us BlueCross BlueShield of Western New York is a division of HealthNow New York Inc., one of New York’s leading health care companies that provides access to quality health care and solutions for members throughout Upstate New York. Since 1936, BlueCross BlueShield has helped millions of people gain access to health care. Headquartered in Buffalo, NY, the company is an independent Licensee of the BlueCross BlueShield Association. As the region’s leading health plan, serving over 800,000 members, BlueCross BlueShield believes in taking small steps towards healthier living. You can visit our website at Title Account Specialist Position Posting Location Buffalo Status Full Time Regular Hours 8:30 a.m.-5:00 p.m. Job Description Responsible for the maintenance of subscriber and member eligibility activity and the generation of accurate and timely bills for a specific set of subscribers and groups; resolves questions from groups and subscribers regarding eligibility and billing utilizing departmental, corporate and regulatory guidelines; reconciles premium payments and reports accurate receivable information. Primary Responsibility Performs other duties of a similar nature that are necessary and not inconsistent with this position or pay grade Delivers customer service in a professional, polite and efficient manner Maintains confidentiality and adheres to HIPAA regulations Performs all job duties efficiently, accurately and at an acceptable rate of performance Reconciles premium payments for subscribers and groups:
•Works with assigned subscribers and groups to ensure billing specifications are met
•Assists in identification and resolution of delinquent accounts
•Corresponds with employer groups and external customers through written or verbal communication as defined within the job responsibilities; this may include on-site visits with prior management approval
•Researches discrepancies, takes appropriate action and notifies client Responds to and resolves subscriber, employer group and internal inquiries:
•Researches eligibility issues and determines resolution from available on-line tools, resources and guidelines
• Documents resolution and actions taken Processes eligibility transactions on a daily basis, to maintain accurate membership data:
•Reviews subscriber enrollment documents
•Obtains missing information; confirms data is appropriate
•Researches eligibility questions and determines outcome based on the established guidelines in various tools and Desk Levels
•Updates eligibility data in the system
•Notifies appropriate internal or external customers by written correspondence or verbal communication
Knowledge and Skills Must meet qualifications to perform the job including satisfactory completion of all training and testing Typing Skills : 30 WPM Microsoft Excel test Job Content test - successful completion Ability to multitask in fast paced environment Well organized with ability to adapt to changing business environment; exhibits attention to details and time management skills Proficiency in English language skills, including spelling, punctuation and grammar, in both written and verbal communication Ability to effectively communicate with internal and external contacts in a professional manner Working knowledge of personal computer and application software such as Microsoft Office Ability to utilize basic office equipment including PC, scanner, telephone, copier, printer, fax, calculator Computer Software typically used: Facets, Excel, Content Manager, Access Qualifications Problem Solving Skills: Identifies eligibility or billing issues and uses available resources to determine appropriate actions.
External Contacts: Subscribers, Employer Groups (some travel as requested)
Experience 1 year previous related experience One(1)year related experience Education Required Education:HS/GED (N/A)Preferred Education:HS/GED (N/A) Working Conditions Must be able to work in an office environment Travel to employer group locations, as required. Physical Effort: Minimum; typical of most office work. Mostly sedentary work. Weight: lift/carry/push/pull under 10 lbs. Prolonged Standing Walking Repetitive Motion Reaching Bending Manual Dexterity Req: Eye-hand coordination and manual dexterity sufficient to effectively utilize various office equipment (phone, computer, fax machine, printer, copier, filing cabinet, etc) Manual Dexterity Req: Eye-hand coordination and manual dexterity sufficient to effectively use a computer with all its components for prolonged periods of time and for the majority of required tasks Vision Req: Close vision (clear vision at 20 inches or less) Vision Req: Distance (clear vision at 20 feet or more) EEO Statement All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status. Removal Date 02-Jul-2019

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