Sr. Call Center Service Assoc

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health.  For over 90 years , we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience.  Our members are our neighbors, our friends, and our families.  It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us.

We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.

About the Role

Resolve complex customer inquiries received by phone or though written correspondence. Provide excellent service to customers. Coach and mentor junior staff members.

What You'll Do

Responsibilities:

• Receive escalated customer inquiries and provide second level resolution by initiating or continuing investigation process, utilizing available resources and accurately documenting customer inquiry and actions taken in accordance with departmental quality guidelines.
• Follow up on unresolved high priority/complex issues to ensure they are brought to conclusion in a timely manner.
• Serve as a liaison for key internal and external operational contacts to ensure that an optimal level of service is provided to customers.
• May assist in monitoring and managing team-s call volume and inventory including tracking and trending key customer service issues and reporting them to management.
• Deliver an excellent customer service experience while meeting quality and production standards.
• Perform other relevant tasks as assigned by management.

What You Bring

• Education/Experience: High School Diploma/GED required
• 18 months+ call center/customer service experience required
• Health insurance industry experience required.
• Knowledge: Medical terminology and medical billing coding required
• Knowledge of multiple claims systems preferred
• Skills and Abilities: Excellent Customer Service skills
• Ability to work in a high pressure, fast pace environment
• Keyboarding proficiency
• PC proficiency
• Strong verbal and written communication
• Interpersonal skills (i.e. active listening)
• Strong investigative and analytical skills
• Ability to multitask
• Ability to manage and diffuse irate calls
• Time management skills
• Flexibility and adaptability
• *The employer may require an employee to pass a test(s) as part of determining whether the applicant meets the minimum qualifications for the job.
• Why Horizon?
• At Horizon, you’ll do meaningful work that directly improves lives—while being supported by a mission‑driven organization that values expertise, collaboration, and growth.  We believe that when our people thrive, our communities do too.  If you are passionate about making an impact, we’d love to hear from you!

Disclaimer:

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware. Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law.  Horizon will consider

reasonable accommodation requests as part of the recruiting and hiring process.