Regence (Fep) Customer Service Professional I - Fulltime Remote In Wa, Id, Or And Ut

Regence (FEP) Customer Service Professional I

Fulltime Remote in WA, ID, OR and UT. Candidates outside of these states will not be considered.

Starting pay range $16.20 - $20.10 DOE and Location. HR will reach out and provide specific information.

Call Center hours are Monday - Friday, 7:00am - 6:00pm PDT

Start date: Monday, October 2nd, 2023

IMPORTANT: We will be conducting verification of employment on your current and past employment if selected to hire. Please make sure you are applying with the most updated resume with correct dates of employment.

Primary Job Purpose

Due to growth of our company and department, we are looking to expand our team. Bring your excellent customer service skills to the FEP (Federal Employee Program) Customer Service role! As an FEP Customer Service Professional, you will inform, educate, and assist members, providers, other health-care professionals, or other provider representatives on recorded phone lines regarding benefits, claims and eligibility.

General Functions And Outcomes

• Maintain confidentiality and sensitivity in all aspects of internal and external contacts.
• Be the primary contact between Cambia and the consumer.
• Manage large volume of calls daily, prioritize follow-through and document member and provider inquiries and actions on tracking system and/or by completing logs. May generate written correspondence and process document requests.
• Quickly and accurately assess provider and member inquiries and requirements by establishing rapport to understand their service needs. Identify errors promptly and implement corrective steps to resolve.
• Comply with the standards of the Federal Employee Program as they relate to the employee’s responsibility to meet BlueCross BlueShield Association (BCBSA) standards and company goals.
• Successfully complete training period and meet dependability, timeliness, accuracy, quantity, and quality standards as established by department. Study, review and learn information, procedures, and techniques for responding to a variety of inquiries.
• Determine benefit payments, maximum allowable fees, co-pays, and deductibles from appropriate contracts.
• Explain benefits, rules of eligibility and claims payment procedures, pre-authorizations, medical review and referrals, and grievance/appeal procedures to members and providers to ensure that benefits, policies, and procedures are understood.
• Assist in identifying issues and trends to improve overall customer service.
• Work is subject to audit/checks and requires considerable accuracy, attention to detail and follow-through.
• Communicate with members, providers, healthcare professionals, agents/brokers, attorneys, group administrators, other member representatives, internal staff, and the general public with inquiries regarding benefits, claim payments and denials, eligibility, decisions, and other information through various media – oral, written and on-line communications.

Minimum Requirements

• Learn, retain, and interpret new or evolving information, procedures, and policies and communicate them effectively.
• Make decisions and exercise good judgment in a sophisticated and constantly evolving environment.
• Communicate effectively orally and in writing, using accurate punctuation, spelling, grammar, and proof-reading skills.
• Knowledge of medical terminology and coding preferred.
• Demonstrate initiative in researching and resolving benefit and eligibility issues.
• Exercise discretion on critical and confidential matters.
• Work under stress and pressure and respond to inquiries with tact, diplomacy, and patience.
• Strong customer-service skills, including courteous telephone etiquette.
• Work in a team environment.
• Proficient PC skills and prior experience in a PC environment.
• Apply mathematical concepts and calculations.

Normally To Be Proficient In The Competencies Below

Customer Service Professional would have a high school diploma or equivalent and 6 months of customer service call center experience or 6 months of customer service experience such as insurance, retail, banking, restaurant, hospital medical office or other experience with extensive customer service contact or equivalent combination or education and experience.

Work Environment

• May be required to work outside normal hours.
• Our call center is open 7am-6pm (PST) M-F.
• May be required to work overtime.

The starting hourly wage for this job is $16.20 - $20.10/hour, depending on candidate's geographic location and experience.

The annual incentive payment target for this position is 5%.

Some Highlights

Base pay is just part of the compensation package at Cambia that is supplemented with an exceptional 401(k) match, bonus opportunity and other benefits. In keeping with our Cause and vision, we offer comprehensive well-being programs and benefits, which we periodically update to stay current.

• Paid time off varying by role and tenure in addition to 10 company holidays
• Annual employer contribution to a health savings account ($1,200 or $2,500 depending on medical coverage, prorated based on hire date)
• Up to $225 in Amazon gift cards for participating in various well-being activities. for a complete list see our External Total Rewards page.
• Up to 12 weeks of paid parental time off (eligible day one of employment if within first 12 months following birth or adoption)
• Medical, dental, and vision coverage for employees and their eligible family members
• Up to a 6% company match on employee 401k contributions, with a potential discretionary contribution based on company performance (no vesting period)
• One-time furniture and equipment allowance for employees working from home

We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.

If you need accommodation for any part of the application process because of a medical condition or disability, please email [email protected]. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy. As a health care company, we are committed to the health of our communities and employees during the COVID-19 pandemic. Please review the policy on our Careers site.