Health Services Technician - Remote AZ

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.

QUALIFICATIONS

REQUIRED QUALIFICATIONS

Required Work Experience

• 1 year experience in healthcare, health insurance, or related customer service (Level 1)
• 3 years experience in healthcare, health insurance, or related customer service (Level 2)
• 5 years experience in healthcare, health insurance, or related customer service (Level 3)

Required Education

• High-School Diploma or GED in general field of study (All Levels)

Required Licenses

• N/A

Required Certifications

• N/A

PREFERRED QUALIFICATIONS

Preferred Work Experience

• 1 years experience in healthcare, health insurance, or related customer service AND 1 year experience in claims examination, health insurance, customer service, call center, medical office, or other healthcare-related field (Level 1)
• 4 years experience in healthcare, health insurance, or related customer service AND 2 years experience in claims examination, health insurance, customer service, call center, medical office, or other healthcare-related field (Level 2)
• 6 years experience in healthcare, health insurance, or related customer service AND 3 years experience in claims examination, health insurance, customer service, call center, medical office, or other healthcare-related field (Level 3)

• Associate's Degree in general field of study

• N/A

• N/A

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,