Health Services Technician (Justice Technician) - Remote AZ

Requirements

• Required Qualifications
• Required Work Experience
• Level 1: 1 year
• Level 2: 3 years
• Level 3: 5 years
• Experience in healthcare, health insurance, or related customer service
• Required Education
• High School Diploma or GED in general field of study (All Levels)
• Required Licenses
• N/A
• Required Certifications
• Preferred Work Experience
• Level 1: 2 years
• Level 2: 4 years
• Level 3: 6 years
• 1 year / 2 years / 3 years experience in claims examination, health insurance, customer service, call center, medical office, or other healthcare-related field
• Preferred Education
• Associate's Degree in general field of study
• Preferred Licenses
• Preferred Certifications
• Essential Job Functions and Responsibilities
• Level 1 - Performs job functions under general supervision or peer review
• Identify, research, process, resolve and respond to customer inquiries and correspondence via telephone, written communication and/or in person.
• Answer a diverse and high volume of health insurance customer calls or correspondence on a daily basis.
• Maintain complete and accurate records per department policy.
• Maintains member information in a confidential manner and ensures HIPAA compliance at all times.
• Meet quality, quantity and timeliness standards to achieve individual and departmental performance goals as defined within the department guidelines and required by State, Federal and other accrediting organizations.
• Explain to customers a variety of information concerning the organization's services, including but not limited to, contract benefits, changes in coverage, eligibility, claims, BCBSAZ programs, community resources, provider networks, etc.
• Demonstrate ability to apply plan policies and procedures effectively.
• Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries.
• Research, gather and conduct preliminary analysis of data for department and corporate reporting.
• Maintain all standards in consideration of State, Federal, BCBSAZ and other accreditation requirements.
• Ensure confidentiality and control access to sensitive information.
• Maintains productivity and accuracy requirements set for this level.
• Assists in development of procedures and/or desk levels for assigned processes, as needed and develops and assists in implementation of new policies and/or desk levels.
• Maintains effective communication (verbal and written), both formal and informal with internal and external customers.
• Maintains knowledge of activities in assigned area and possesses the ability to provide assistance as necessary.
• Able to work effectively and collaboratively with interdisciplinary teams.
• Positively adapts to a changing work environment with flexibility and recognizes the impact the change will have on the department process.
• Adapts to changing work environ

Benefits

Additional Information

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions. At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements: Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month Onsite: daily onsite requirement based on the essential functions of the job Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week. This remote work opportunity requires residency, and work to be performed, within the State of Arizona. Purpose of the Job Responsible for research and triage of records and other documentation to ensure requests are processed accurately, timely, professionally and according to regulations. Works with team, providers and members to provide services that put our member first.

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