What are the responsibilities and job description for the Account Specialist I position at Capital Blue Cross?
Position Description
Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market-driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more.
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 Account Specialist is responsible for providing accurate and timely service to Individual Account members by monitoring and maintaining correct and updated billing and enrollment information. This includes APTC changes, HICS cases, address changes, terminations, new enrollments, refunds and invoicing individual members. This incumbent responds to phone, written and electronically generated inquiries from individuals and various internal customers needing assistance. The Specialist must use knowledge of existing procedures, Facets, business practices, policies and inter-relationships to build customer trust to ensure innovative and cost effective solutions in reconciling enrollment, customer service inquiries and billing issues. The Specialist is responsible for providing support to internal customers to resolve member issues in an expedient manner ensuring customer satisfaction. The incumbent works as a team player representing the unit and Capital Blue Cross.
Responsibilities And Qualifications
Sedentary work involving significant periods of sitting, talking, hearing, keying and performing repetitive motions. Work requires visual acuity to perform close inspection of written and computer generated documents as well as a PC monitor. Working environment includes typical office conditions.
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 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.
Capital Blue Cross is an independent licensee of the Blue Cross Blue Shield Association. We are an equal opportunity employer and do not discriminate on the basis of race, color, religion, national origin, gender, sexual orientation, gender identity, age, genetic information, physical or mental disability, veteran status, or marital status, or any other status protected by applicable law.
Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market-driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more.
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 Account Specialist is responsible for providing accurate and timely service to Individual Account members by monitoring and maintaining correct and updated billing and enrollment information. This includes APTC changes, HICS cases, address changes, terminations, new enrollments, refunds and invoicing individual members. This incumbent responds to phone, written and electronically generated inquiries from individuals and various internal customers needing assistance. The Specialist must use knowledge of existing procedures, Facets, business practices, policies and inter-relationships to build customer trust to ensure innovative and cost effective solutions in reconciling enrollment, customer service inquiries and billing issues. The Specialist is responsible for providing support to internal customers to resolve member issues in an expedient manner ensuring customer satisfaction. The incumbent works as a team player representing the unit and Capital Blue Cross.
Responsibilities And Qualifications
- 25% - Responsible for the creation of member eligibility within the Facets System for Individual Membership, which includes Blue Reliance, Security, On/Off exchange, Dental, Vision and CHIP.@@The enrollment of member information is completed according to all policies, procedures and mandates within a specified time frame.@@This also includes canceling contracts, processing name changes and setting up Check it out banking information
- 25% - Responsible for researching returned refund checks, completing fund transfers and processing refunds from daily reports.@@The payments are reconciled according to all policies and procedures within the specified time frame.@@Additional financial transactions may include transferring premium dollars, and completing refunds.
- 25% - Responds to telephone and/or written inquiries received from Customer Service, IA Account Executives and other internal units.
- 25% - Reviews, processes and researches various member reports and provides explanations as needed (i.e., Group Billing Error Report, Request Ad Hoc Reports, CL-M-150 6 Prem Register Report, PREF Refund Report)
- Must possess excellent keyboarding skills to operate a PC and other office equipment. (e.g., copy machine, fax machine, printer, calculator, etc.) Must be proficient in the use of PC software and end user computing tools. (e.g., Windows NT, Email, Instant Messenger, Microsoft Excel and Microsoft Word). Must be familiar with logging into various Computer applications and databases.
- Familiar with basic mathematical concepts used in the calculation of subscriber premium refunds and invoicing.
- Knowledge of billing and enrollment policies and procedures and government regulations associated with Individual Account Subscribers
- Must be familiar with Work desk (Image) and workflow.
- Ability to effectively communicate verbally and in writing.
- Ability to work independently to perform duties with minimal supervision.
- Must have the ability to adapt to constant changing priorities and keeping daily responsibilities on task.
- Must be willing and able to work overtime during peak periods, which typically fall between November and February.
- Performs other related duties and assignments as directed.
- Must possess a high school diploma or G.E.D.
Sedentary work involving significant periods of sitting, talking, hearing, keying and performing repetitive motions. Work requires visual acuity to perform close inspection of written and computer generated documents as well as a PC monitor. Working environment includes typical office conditions.
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 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.
Capital Blue Cross is an independent licensee of the Blue Cross Blue Shield Association. We are an equal opportunity employer and do not discriminate on the basis of race, color, religion, national origin, gender, sexual orientation, gender identity, age, genetic information, physical or mental disability, veteran status, or marital status, or any other status protected by applicable law.