Customer Services Concierge Support, Intermediate (Shared Advantage)

Your Role

 

The Shared Advantage team is a multi-functional team providing services and support for third-party administrators (TPA), including claims processing, high dollar review, written correspondence, client services concierge phone support, and e-mail correspondence. The Customer Services Concierge Support Intermediate will report to the Operations Supervisor. In this role you will resolve incoming calls and real-time chats from the TPA’s concerning claims status and authorizations. You'll learn to process and adjust simple claims, apply return files, respond to written correspondence, and respond to email correspondence.

Your Work

 

In this role, you will:

• Resolve incoming calls as needed from third-party administrators regarding claims status and prior authorizations
• Assist members by locating providers within the Blue Shield network and finding the status of a prior authorization
• Answer email inquiries from TPA's regarding claims status and prior authorization       
• Process and adjust simple claims, and apply return files
• Drive and support a positive team culture

Your Knowledge and Experience

 

• Requires a high school diploma or GED
• Requires at least 3 years of prior relevant experience
• Ability to problem-solve and resolve complex claims inquiries
• Maintain professionalism and a positive attitude
• Be dependable, reliable, responsible, and can work independently
• Have excellent interpersonal communication skills and work well within a team