This job opportunity is open to candidates who live in Blue, as well as those who are willing to relocate for the position. To be eligible for this job, you must have completed High School as a minimum requirement. If you succeed in your application, the salary for this job will be $35,000 - 45,000 / year. December 22, 2023 is when the job offer for the Customer Service Rep I position became available, and it will expire on March 21, 2024. full time work can be a great way to build your resume and gain valuable experience.
Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware Job Summary: This position is accountable for providing timely and accurate customer service through routine inquiries from insured's and providers regarding billing, general claim questions, credentialing and case management within Horizon Casualty Services, Inc. Communicates information regarding status on billing claims and provider network participation.
- Responds to general questions from insured and providers regarding provider networks, billing, correspondence, and claims.
- Coordinates claim activities on behalf of insured and providers by interacting with medical and case management personnel to provide information and resolve issues.
- Performs routine research related to claim history, contract benefits, and system guidelines to determine over payments, duplicates, under payments, or receipt of no payment for claim resolution.
- Refers non-routine claim inquiries to Nurse Case Managers, Nurse Advocates or Medical Payment Specialist if inquiry cannot be determined from available resources.
- Responds to pre-certification request and three-(3) point contact inquiries by identifying current claim status.
- Responds to customers on check inquiries and payment resolutions.
- Completes other assigned functions as requested by Management.
Core Individual Contributor Competencies:
- Personal and professional attributes that are critical to successful performance for Individual Contributors:
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- Requires High School diploma or GED equivalent. Prefer Bachelors degree.
- Requires a minimum of two (2) years customer service experience.
- Requires working knowledge of personal computers and supporting software in windows based environment including MS Office Products and email application systems.
- Prefers knowledge of medical terminology and/or case management services.
- Prefers knowledge of NJ Workers'Compensation and No-Fault laws.
Skills and Abilities:
- Information gathering
- Problem Solving
- Planning/Priority Setting
Salary Range: $34,400 - $45,045 This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:
- Comprehensive health benefits (Medical/Dental/Vision)
- Retirement Plans
- Generous PTO
- Incentive Plans
- Wellness Programs
- Paid Volunteer Time Off
- Tuition Reimbursement
Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.
The job posting provides all the necessary information to make a well-informed decision about the job. In the world of job applications, accuracy is everything – make sure that your application reflects this. Please take the time to carefully read the job posting before submitting an application. We encourage individuals who are confident in their ability to fulfill the responsibilities to apply for this job.