Job description

****This position is eligible for remote employment. Must be willing to work on Eastern Standard Time***

Ready to help us transform healthcare? Bring your true colors to blue.

Inter-Plan Service Representatives work in a fast-paced environment and are tasked with multiple functions and responsibilities. As the Liaison for Provider Services, Finance and sister Blues Plans, the Inter-Plan Service Representative plays an important role in achieving customer satisfaction, transactional metrics and plan to plan performance goals set forth by BCBSA. Our ability to provide outstanding service to our customers is a top priority for every associate.
Inter-Plan Service Representatives work in a fast-paced environment and are tasked with multiple functions and responsibilities. As the liaison for Provider Services, Finance and other Blues plans, the Inter-Plan Service Representative plays an important role in achieving customer satisfaction, transactional metrics and plan to plan performance goals set forth by BCBSA. Our ability to provide outstanding service to our customers is a top priority for every associate.

Key Responsibilities: **

• Review and resolve adjustments and informational requests from various internal areas and sister Blues Plans
• Resolve pending adjustments initiated and suspended for manual review by InterPlan Host Service, Provider Services, Finance
• Process adjustments using NASCO and BlueSquared
• Research & resolve inquiries in NASCO /BlueSquared received from a Priority Hotline & customer service worksheets
• Resolve adjustment projects received by the Recovery Area
• Identify trends identification and opportunities for process improvements
• Identify and investigate system discrepancies for resolution of issues
• Provide high level of service to both internal and external customers
• Exhibit a spirit of teamwork and contribute ideas for division and company success
• Perform special projects as needed
• Actively participate in workgroups to improve internal processes and streamline workflows
• Analyze and resolve elevated issues from Provider Services, and other Blues Plans

Key Requirements: **

• 1-2 years business experience
• Thorough knowledge of NASCO claims and adjustments required
• Knowledge BlueSquared and Inter-Plan Program required
• Excellent phone manner & demonstrated ability to respond to internal/external customers in a fast paced environment
• Recent work history to support excellent organizational, problem solving, communication, dependability, teamwork and interpersonal skills
• Demonstrated flexibility and willingness to change as business needs change within the organization
• Proven written and verbal communication skills are essential
• Proficiency in Microsoft Office (including Word and Excel)

Education/Relevant Experience: **

• High school diploma; bachelor’s degree preferred

Blue Cross Blue Shield of Massachusetts is an Equal Employment / Affirmative Action Employer. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or expression, or any other characteristics protected by law.

Blue Cross Blue Shield of Massachusetts will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with Blue Cross Blue Shield of Massachusetts's legal duty to furnish information.

Minimum Education Requirements:
High school degree or equivalent required unless otherwise noted above

Job Type: Full-time

Pay: $43,000.00 - $45,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Health savings account
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift

Supplemental pay types:

• Bonus pay

Experience:

• healthplan: 1 year (Required)
• Customer service: 1 year (Required)
• NASCO: 1 year (Required)
• Health Insurance Claims: 1 year (Required)

Work Location: Remote

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