What are the responsibilities and job description for the Associate Support Spec position at Blue Cross & Blue Shield of Rhode Island?
Pay Range
$52,800.00 - $65,800.00
Please email HR_Talent_AcquisitionTeam@bcbsri.org if you are a candidate seeking a reasonable accommodation for the application and/or interview process.
At BCBSRI, our greatest resource is our people.
We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do—not just for our members, but for our employees as well.
We recognize that to do your best work, you have to be your best self.
It’s why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees.
Our culture is one of belonging.
We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you’re at in the organization, you’re an integral part of our team and your input, thoughts, and ideas are valued.
Join Others Who Value a Workplace For All.
We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders.
We’re dedicated to serving Rhode Islanders.
Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state—building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer.
ESSENTIAL JOB FUNCTIONS (Describe nature and scope of position, maximum of 8):
Minimum Education and Experience:
Environmental Conditions: Noise Level
Work near moving mechanical parts. Quiet
Work in high, precarious places. Moderate
Outdoor weather conditions. Loud
Typical office conditions.
Other Work Environments: N/A
PHYSICAL DEMANDS (select All Applicable)
Physical Activity : Physical Exertion:
Sit, stand, walk, talk, and hear. Lift up to 10 pounds.
Reaching with hands and arms. Lift up to 25 pounds.
Climbing or balancing. Lift up to 50 pounds.
Stoop, kneel, crouch or crawl. Lift more than 50 pounds.
Vision Requirements
Close vision.
Distance vision.
Peripheral vision.
Depth perception.
Ability to adjust focus.
Other Physical Demands: N/A
Access To Information
Assign sensitivity level based on the highest level of data sensitivity, and the requirements of specific laws governing the protection or disclosure of this information, required of this position.
___ Level 1: Low Sensitivity- Data used in these positions requires minimal protection. Risks associated with disclosure of this data are minimal, and only minimal precautions to protect the data need to be taken. Data that is in the public domain, for which any unauthorized disclosures could be expected not to adversely affect the individual and/or the organization.
___ Level 2: Moderate Sensitivity - Data used in these positions is most often collected for analytical purposes and has importance to BCBSRI and its business partners and must be protected. This category would include information of a proprietary nature such as: management information concerning workload, performance, staffing, research, financial and statistical data, and similar data usually in statistical form. This data is not individually identifiable to members. It also includes items such as directories, organizational charts, policies, procedures, and other documents pertaining to internal corporate operational processes.
X Level 3: High Sensitivity – Data used in these positions is sensitive in nature and requires the greatest and most stringent security safeguards as the user level. This category includes, but is not limited to, all individually identifiable data and health care information, however maintained, that require protection due to the risk and magnitude of loss or harm that could result from inadvertent or deliberate disclosure, alteration, or destruction of the data; payment information, benefit information, employee personal information or payroll information, proprietary information, and correspondence and documents that are considered highly sensitive or critical to the organization. Information that could put this sensitive information at risk is also included in this category, such as passwords, encryption keys and detailed information technology related information.
Disclaimer
This description is not intended to be a complete statement of job content; rather to act as a guide to the essential functions performed. Management retains the discretion to add to or change the duties of the position at any time.
Location:
Role
BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:
The law requires an employer to post notices describing the Federal laws. Please visit www.eeoc.gov/know-your-rights-workplace-discrimination-illegal to view the "Know Your Rights" poster.
$52,800.00 - $65,800.00
Please email HR_Talent_AcquisitionTeam@bcbsri.org if you are a candidate seeking a reasonable accommodation for the application and/or interview process.
At BCBSRI, our greatest resource is our people.
We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do—not just for our members, but for our employees as well.
We recognize that to do your best work, you have to be your best self.
It’s why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees.
Our culture is one of belonging.
We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you’re at in the organization, you’re an integral part of our team and your input, thoughts, and ideas are valued.
Join Others Who Value a Workplace For All.
We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders.
We’re dedicated to serving Rhode Islanders.
Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state—building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer.
ESSENTIAL JOB FUNCTIONS (Describe nature and scope of position, maximum of 8):
- Respond to inquiries from internal and external customers; facilitate problem resolution through research. Refer call to appropriate resources in a timely manner.
- Interact with clinical staff to obtain health care information necessary for data entry, payment authorization, or quality initiatives. Perform data entry into the medical information system and other applicable data bases.
- Prepare correspondence and survey information for clinical staff; ensure adherence to regulatory, accreditation, and departmental standards.
- Research claims and coverage data and verify eligibility for payment purposes.
- Prepare monthly and ad hoc reports to support operational needs of the division and other duties as assigned to support corporate objectives.
- Assist team with department initiatives and projects.
- Perform other duties as assigned.
Minimum Education and Experience:
- High school degree
- Up to two years experience in a medical, hospital, or third party payer setting
- Working knowledge of Microsoft Office including Excel, and Word
- Experience in claims
- Experience in a managed care environment
- Knowledge of state and federal health regulations and accreditation standards (e.g., NCQA, URAC, DOH, DHS, CMS)
- Working knowledge of medical terminology
- Computer navigation skills
- Written and verbal communications skills
- Time management skills
- Ability to collect and organize data
- Ability to work independently
- Ability to meet established time and quality standards
- Ability to exercise sound judgment
Environmental Conditions: Noise Level
Work near moving mechanical parts. Quiet
Work in high, precarious places. Moderate
Outdoor weather conditions. Loud
Typical office conditions.
Other Work Environments: N/A
PHYSICAL DEMANDS (select All Applicable)
Physical Activity : Physical Exertion:
Sit, stand, walk, talk, and hear. Lift up to 10 pounds.
Reaching with hands and arms. Lift up to 25 pounds.
Climbing or balancing. Lift up to 50 pounds.
Stoop, kneel, crouch or crawl. Lift more than 50 pounds.
Vision Requirements
Close vision.
Distance vision.
Peripheral vision.
Depth perception.
Ability to adjust focus.
Other Physical Demands: N/A
Access To Information
Assign sensitivity level based on the highest level of data sensitivity, and the requirements of specific laws governing the protection or disclosure of this information, required of this position.
___ Level 1: Low Sensitivity- Data used in these positions requires minimal protection. Risks associated with disclosure of this data are minimal, and only minimal precautions to protect the data need to be taken. Data that is in the public domain, for which any unauthorized disclosures could be expected not to adversely affect the individual and/or the organization.
___ Level 2: Moderate Sensitivity - Data used in these positions is most often collected for analytical purposes and has importance to BCBSRI and its business partners and must be protected. This category would include information of a proprietary nature such as: management information concerning workload, performance, staffing, research, financial and statistical data, and similar data usually in statistical form. This data is not individually identifiable to members. It also includes items such as directories, organizational charts, policies, procedures, and other documents pertaining to internal corporate operational processes.
X Level 3: High Sensitivity – Data used in these positions is sensitive in nature and requires the greatest and most stringent security safeguards as the user level. This category includes, but is not limited to, all individually identifiable data and health care information, however maintained, that require protection due to the risk and magnitude of loss or harm that could result from inadvertent or deliberate disclosure, alteration, or destruction of the data; payment information, benefit information, employee personal information or payroll information, proprietary information, and correspondence and documents that are considered highly sensitive or critical to the organization. Information that could put this sensitive information at risk is also included in this category, such as passwords, encryption keys and detailed information technology related information.
Disclaimer
This description is not intended to be a complete statement of job content; rather to act as a guide to the essential functions performed. Management retains the discretion to add to or change the duties of the position at any time.
Location:
Role
BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:
- In-office: onsite 5 days per week
- Hybrid: onsite 2-4 days per week
- Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia
The law requires an employer to post notices describing the Federal laws. Please visit www.eeoc.gov/know-your-rights-workplace-discrimination-illegal to view the "Know Your Rights" poster.
Salary : $52,800 - $65,800
