Position Description

At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.” 

The Member / Provider Services Representatives (“MSRs” / “PSRs”) are the front-line team at Capital Blue Cross (“CBC”) and are responsible for handling all customer inquiries through multiple channels (i.e., phone, web, electronic, and/or face-to-face) by using material and tools with accuracy and precision. This incumbent will be responsible for effectively presenting and discussing our products and services, creating and maintaining positive relationships and for exceeding quality, productivity, and ultimate performance goals. This incumbent will be required to initially attend a training class in addition to ongoing periodic refresher trainings to service our customers as business needs permit.

Responsibilities and Qualifications

Customer-Focus:

• Manage telephone, electronic, and face-to-face interactions professionally, efficiently and with excellent communication skills.
• Effectively present and discuss the products and services to external and internal customers with integrity and understanding and accuracy with every interaction.
• Focus on customer retention through first call resolution of concerns.
• Establish and maintain positive relationships with customers on behalf of the company by taking personal and complete responsibility for each customer interaction.
• Ensure all customers’ needs are completely met, timely, without elevation if possible.
• If business needs permit, support the efforts of CBC sales representatives by conducting onsite and/or community-based educational meetings.

Performance standards, business metrics and process improvements:

• Large emphasis on quality, productivity, adherence, handle time, and not negatively affective and jeopardizing CBC customer relations, internally and externally
• Complete ongoing training to stay abreast of products, services and policy changes.
• Improve quality of work on a daily basis by learning and employing new skills or adapting pervious processes to mirror the fit-for-excellence company culture.
• Recognize, document, and alert supervisors of trends in customer calls.
• Conduct self in a manner consistent with the values of the organization.

Qualifications:

• Must be able to build and/or retain excellent customer relationships by presenting a positive and cooperative attitude via multi-channel connections with customers.
• Ability to deliver ‘delightful’ customer service experiences and build customer satisfaction and loyalty with both internal and external customers.
• Ability to actively listen paired with demonstrate empathy for customers.
• Be service and solution oriented by actively looking for ways to help.
• Be patient, stress tolerant and show empathy to customers, both internal and external
• Must possess a strong attention to detail and an interest in preventing errors.
• Demonstrate critical thinking, problem solving, and decision-making abilities.
• Ability to critically observe, analyze, think creatively, and resolve customer complaints.
• Demonstrate ability to be independent, self-sufficient, dependable and professional.
• Demonstrate intrinsic initiative, time management.
• Ability to effectively de-escalate upset callers with minimal supervisory intervention.
• Demonstrate ability to collaborate with others and work as a member of a team.
• Ability to thrive in a dynamic working environment, multi-task, and adapt quickly.
• Ability to accept feedback, learn, and adapt from guidance to be successful.
• Ability to mentor peer group in best practice standards as well as positively spread continuous changes to processes and the responsive health care environment.
• Have the capacity to up-sell and speak highly of our products and company.
• Have a strong work ethic, passion for our products and our customers’ experiences.
• Foster an inclusive culture of diversity, working well with others.
• Must be able to meet quality, productivity, and behavior expectations.

Knowledge, Skills, and/or Abilities:

• Demonstrated competency in computer programs such as internet browsers, Microsoft Outlook, Word, Excel, PowerPoint, and etc.
• Must possess basic reading and arithmetic skills (reading and math comprehension)
• Must possess above average verbal and written communication skills.
• Average or above average social and emotional intelligence candidates preferred.
• Experience with customer interaction preferred, but not required.

Education, Certification, and Licenses:

• Must have a High School Diploma or GED
• Bi-lingual (Spanish) a plus
• License to sell (a plus, may be required for advanced positions)

Work Environment:

• Call Center environment.
• Qualified candidate must be flexible to work varied shift schedules that may span anywhere between 8:00 a.m. to 8:00 p.m., any day of the week.

Travel Requirements:

• Amount: 5% of the time
• Some travel may be required for training sessions and/or between buildings.
• If working from home, CSRs are required to be readily available to travel to the appropriate work site locations as needed per business needs and in compliance with the corporate travel and work-at-home polices.
• Advanced positions may have minimal travel to group customers for face-to-face meetings.

Physical Demands:

• While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see.
• The employee must be able to work over 40 hours per week.
• The employee must occasionally lift and/or move up to 5 pounds.

Key Interfaces:

• Facets
• Bridges
• Workflow
• Microsoft Office (Outlook, Word, Excel, PowerPoint)
• Availity
• NICE
• NICE Incontact
• ERNIE/Salesforce

The job demands described here are representative of those that must be met by an employee to successfully perform the functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job. It is intended to be a reflection of those principal job elements essential for recruitment and selection, for making fair job evaluations and for establishing performance standards. The percentage of time spent performing the various job duties is not absolute. The incumbent shall perform all other functions and/or be cross trained as shall be determined by the sole discretion of management, who has the right to amend, modify, or terminate

About Us

We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a diverse and caring team of supportive colleagues, and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.