Job Description
Responsible for a customer-facing, service relationship with clients, maintaining a high level of engagement around service delivery, issue resolution and healthcare initiatives unique to clients. Takes a multi-faceted and creative approach in managing the overall service strategy for the client. Partners with internal teams to maintain compliance with contractual agreements, effective cost control measures, policies, procedures and workflows to resolve service inquiries. Drive excellence in sales delivery and support by efficiently and effectively addressing needs and issue escalations expressed by internal team members. Build sustainable relationships with internal team members by providing market-leading service and support experience.Identifies, analyzes and resolves complex operational issues impacting clients. Intake, manage, track and resolve inquiries, issues, and escalations raised by client representatives, agents/consultants. Monitor channels for inquiry intake, documenting and managing client representative concerns.
Designs, develops and maintains the integrity of service plans. Arranges and facilitates all meetings to review the service plan and client specific issues.
Secures the service deliverables with the account and identifies task and expectations from the client and fulfills deliverables. Reviews the status of the deliverables with the internal teams involved.
Escalate high-priority or high-risk issues to Client Success Lead as needed to determine and carry out resolution.
Develop relationships with clients to understand their goals, processes, procedures and systems to provide support for the relationship with Blue Cross NC. Provides plan/benefit administration support to client. Administer and monitor client contract provisions, and maintain compliance with contractual agreements. Addresses client customer concerns and non-compliance contract/administrative issues. Coordinates the required corrective action as identified via data and root cause analysis.
Maintains a collaborative relationship with sales. Reports issues to sales, performs research, identifies issues, and root cause and proposes solutions. Identifies the support area to manage the analysis for root cause issues, as needed. Partner with sales team and cross-organizational support staff to identify and execute solutions for client service requests. Develops and manages documentation that captures issues across the plan, dates for completion and other key deliverables.
Represents Blue Cross NC in critical service related customer meetings to address issues, or administrative inefficiencies. Participates in customer-facing sales meetings as requested by the sales team.
Delivers client specific reporting, including reporting related to service issues and network disruption, and assists with communication plans. Reviews service related reporting with clients.
Leverage historic client inquiry and issue data to actively identify future resolution, optimizing inquiry management and issue resolution
Identifies operational inefficiencies and collaborates with Sales team to create a strategy to address. Identify and document best practices, and communicate key client issue resolution experiences to suggest process, product delivery, and client service improvement opportunities.
Identifies opportunities to control segment and book of business administrative or medical expense and deploys action plans to accomplish specific expense reduction goals. Assists in the analysis of products, identifies any deficiencies and makes recommendations for improvement. Identifies trends with issues.
Hiring Requirements
Bachelor's degree or advanced degree (where required)
3+ years of experience in related field
In lieu of degree, 5+ years of experience in related field
Must be able to obtain a North Carolina Health and Life Insurance license within the 60 days of employment in this position.
Must possess and maintain a valid driver’s license.
What You'll Bring!!
Strong Customer Service
Background Insurance Industry Experience
Excellent Communication Skills
**OPEN TO RESIDENTS OF NC ONLY**
Salary Range
At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.
*Based on annual corporate goal achievement and individual performance.
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