Blue Card Multi Service SpecialistFull-time work from home candidates in WA, ID, OR, UT only.Starting pay range $18.00 - $21.00 an hour depending on experience and location. HR will reach out and provide specific information.Who We Are Looking For Every day, Cambia's dedicated team of Blue Card Specialists are living our mission to make health care easier and lives better.
BlueCard Multi Service Specialist I processes a variety of BlueCard claim types, adjustments and medical records. BlueCard Multi Service Specialists also serves as a liaison between the Provider Contact Center, Provider Networking team, and other business areas to resolve outstanding claim-related issues with other BCBS plans.
Do you have a passion for serving others and learning new things? Do you thrive as a part of a collaborative, caring team? Then this role may be the perfect fit.
Qualifications:High school diploma or equivalent
1 year of experience in Claims or Membership
Call Center/Contact Center Customer Service or equivalent combination of education and experience
Skills and Attributes:PC experience and familiarity with corporate software (e.g., MS Word, Excel, or comparable software) are required, as well as strong claims processing skills and ability to apply medical terminology and ICD-10/CPT coding.
Effective communication and listening skills are essential to promote positive, professional interactions while maintaining confidentiality and sensitivity in all internal and external contacts, as well as providing excellent customer service to customers, providers, members, and internal staff.
The ability to work independently, make decisions, and exercise sound judgment is crucial, along with critical thinking skills to analyze situations and make informed decisions.
Organizational and time management skills are necessary to prioritize workload, meet deadlines, and adapt to changing priorities and workload demands based on the Claims Division's goals.
Reliability, flexibility, and a strong work ethic are expected to meet job requirements, including quality, quantity, timeliness, knowledge, and dependability standards described by department goals.
What You Will Do at CambiaProcess new claims, corrected claims, misrouted claims, and respond to incoming Adjustments Requests from other BCBS plans, ensuring accurate and efficient claims processing.
Apply knowledge of medical terminology, ICD-10, CPT coding, and other resources to resolve claim issues, and request and process needed Medical Records from Providers as necessary.
Recognize and adapt to all policies and procedures that apply to claims, including daily changes in workload/responsibilities based on Claims Division goals/priorities, and maintain confidentiality in all aspects of claims processing.
Maintain accurate and up-to-date documentation, including clear and concise audit trails, and keep all relevant documents, policies, procedures, and guidelines readily accessible to ensure compliance with MTM and Consortium standards.
Meet the demands of the role by working overtime and on weekends as needed, and being flexible to changes that affect the job, including contract changes, procedure or system changes, and other assigned projects or duties as assigned by management.
Your Work EnvironmentDuties performed primarily in an office environment.
Ability to physically perform essential job duties.
May sit and key at PC for extended periods of time.
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