What are the responsibilities and job description for the Technical Specialist Claims position at BCBSM, Inc.?
About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us. This vacancy is the result of the previous employee’s promotion into another role within the organization. The Impact You Will Have This position serves as a resource to claims staff in resolving complex issues. Through this process, this position provides training and mentoring along with coordination, development, and delivery of claims specific training for claims operations staff. This position is responsible for serving as a subject matter expert (SME) internally and for other Blue Plans. Your Responsibilities Serves as primary resource for staff in interpretation of contracts, system, procedures, or policies. Provides guidance to staff while assisting in resolution of difficult and/or sensitive issues. Provides written and verbal feedback to supervisors regarding individual employee performance. Provides supplemental and on-the-job training to new and existing staff in an individual or group setting. Assists the Claims Business Training Unit in the development of training content, lesson plans, job aides and training materials. Identifies and develops training opportunities with claims leadership. Audits individuals work and provides feedback to employees while keeping leadership appraised of the progress of each individual. Analyzes and provides recommendations for possible changes in workflow procedures or situations. Responds to internal customers and other Blue Plans inquiries. Completes assigned special projects that require research, analysis, and documentation. Provides back-up support to leadership. Serve as subject matter expert for other areas by providing mentoring, best practices, development, etc. Willingness to take on complex projects. Determine problem cause, develop, and implement solutions and provide quality communication on outcome. Required Skills and Experience 4 years of related experience. All relevant experience including work, education, transferable skills, and military experience will be considered. Excellent interpersonal skills. Strong presentation skills. Ability to explain complex procedures, products, and concepts. Thorough understanding of company computer applications. Demonstrates conflict resolution skills. Well-developed oral and written communication skills. Demonstrates planning, prioritization and organizational skills. Demonstrates confident and independent decision-making skills. Demonstrated flexibility to adapt to changes in procedures and job assignments. Demonstrated ability to work independently and in a team environment. High school diploma (or equivalency) and legal authorization to work in the U.S. Preferred Skills and Experience Prior insurance or health care experience. Prior experience interacting with customers. Knowledge of operating systems specific to claim processing. Role Designation Teleworker Role designation definition: Teleworking is working full time remote. Hybrid is a minimum of 2 days onsite. Onsite is full-time onsite. Compensation and Benefits $23.81 - $29.76 - $35.71 Hourly Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job. We offer a comprehensive benefits package which may include: Medical, dental, and vision insurance Life insurance 401k Paid Time Off (PTO) Volunteer Paid Time Off (VPTO) And more To discover more about what we have to offer, please review our benefits page. Equal Employment Opportunity Statement At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic. Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: talent.acquisition@bluecrossmn.com. Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association. Chartered in 1933 as Minnesota’s first health plan, this company is one of the most recognized and trusted healthcare brands in the world. It has more members, the largest network of doctors, and more products and services than any other health plan in Minnesota. Headquartered in Eagan, Minnesota.
Salary : $24 - $30
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