Health Services Technician Job at Blue Cross Blue Shield of Arizona (Phoenix)

Job Description

Responsible for research and triage of records and other documentation to ensure requests are processed accurately, timely, professionally and according to regulations. Works with team, providers and members to provide services that put our member first.

Job Responsibility

Identify, research, process, resolve and respond to customer inquiries and correspondence via telephone, written communication and/or in person
Answer a diverse and high volume of health insurance customer calls or correspondence on a daily basis
Maintain complete and accurate records per department policy
Maintains member information in a confidential manner and ensures HIPAA compliance at all times
Meet quality, quantity and timeliness standards to achieve individual and departmental performance goals as defined within the department guidelines and required by State, Federal and other accrediting organizations
Explain to customers a variety of information concerning the organization’s services, including but not limited to, contract benefits, changes in coverage, eligibility, claims, BCBSAZ programs, community resources, provider networks, etc.
Demonstrate ability to apply plan policies and procedures effectively
Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries
Research, gather and conduct preliminary analysis of data for department and corporate reporting
Maintain all standards in consideration of State, Federal, BCBSAZ and other accreditation requirements
Ensure confidentiality and control access to sensitive information
Maintains productivity and accuracy requirements set for this level
Assists in development of procedures and or desk levels for assigned processes, as needed and develops and assists in implementation of new policies and or desk levels
Maintains effective communication (verbal and written), both formal and informal with internal and external customers
Maintains knowledge of activities in assigned area and possesses the ability to provide assistance as necessary
Able to work effectively and collaboratively with interdisciplinary teams
Positively adapts to a changing work environment with flexibility and recognizes the impact the change will have on the department process
Adapts to changing work environment with flexibility and recognizes potential impact with ability to accentuate the positive to maintain/increase staff morale

Requirements

1 year experience in healthcare, health insurance, or related customer service (Level 1)
3 years experience in healthcare, health insurance, or related customer service (Level 2)
5 years experience in healthcare, health insurance, or related customer service (Level 3)
High-School Diploma or GED in general field of study (All Levels)
Intermediate skill in use of office equipment including copier, fax machine, scanner, and telephones
Intermediate PC proficiency
Intermediate skill in word processing, spreadsheet, and database software
Maintain confidentiality and privacy
Practice interpersonal and active listening to achieve high customer satisfaction and departmental communication standards
Interpret and translate policies, procedures, programs and guidelines
Capable of investigative and analytical research
Navigate, gather, input and maintain data records in multiple system applications
Follow and accept instruction and direction
Establish and maintain working relationships in a collaborative team environment

Nice to have

1 years experience in healthcare, health insurance, or related customer service AND 1 year experience in claims examination, health insurance, customer service, call center, medical office, or other healthcare-related field (Level 1)
4 years experience in healthcare, health insurance, or related customer service AND 2 years experience in claims examination, health insurance, customer service, call center, medical office, or other healthcare-related field (Level 2)
6 years experience in healthcare, health insurance, or related customer service AND 3 years experience in claims examination, health insurance, customer service, call center, medical office, or other healthcare-related field (Level 3)
Associate's Degree in general field of study
Intermediate understanding of medical terminology
Intermediate comprehension of anatomy and medical practices
Knowledge of a wide range of subjects pertaining to the organization's service and operations
Analytical knowledge necessary to generate reports based on available data and then make decisions based on reported data
Ability to build synergy and interdependence with a diverse team, in a changing environment

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Health Services Technician

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