Qureos Mentor

Capital Blue Cross

<div>Position Description:
<div>
Base pay is influenced by several factors including a candidate&rsquo;s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market-driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental &amp; Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more.</div><div>
At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it&rsquo;s why our employees consistently vote us one of the &ldquo;Best Places to Work in PA.&rdquo;</div>
The Communications Specialist leads the planning, development, and execution of strategic communication initiatives that support corporate projects, member engagement, and organizational priorities. This role also produces clear, consistent, and on-brand content across multiple channels to help bring those strategies to life.
The Communications Specialist must excel at both working independently and collaboratively with colleagues at varying levels in Marketing, around the company, and with external vendors. The specialist must be a self-starter who demonstrates critical thinking, problem solving, and superior organization and prioritization skills to manage and provide clear, informative, and timely deliverables that optimize our customers&rsquo; experience, while supporting the needs of various internal and external audiences.<div>
Through exceptional communication skills, this position will play a vital role in reinforcing an exceptional member and customer experience by: 
<ul><li>Supporting the seamless, timely implementation of corporate projects, programs, and products.</li><li>Creating or maintaining clear, consistent, and on brand communications for all audiences.</li><li>Keeping internal employees informed of new or changing products, services, etc.</li></ul></div>
Responsibilities and Qualifications:

Direct development and execution of strategic communication plans that support corporate projects by:<ul><li>
Developing and executing communication strategies aligned with project objectives, timelines, and organizational priorities.</li><li>
Translating strategy into clear, compelling content and coordinated deliverables tailored to key audiences both inside and outside of Capital.</li><li>
Collaborating cross functionally to ensure cohesive, timely, and effective execution of communication initiatives.</li></ul>
Perform comprehensive editing for grammar, brand, usage, consistency, accuracy, and style in a fast-paced environment by:<ul><li>
Helping establish and enforce writing standards and quality control measures to ensure consistent messaging, tone, and brand identity.</li><li>
Applying investigative and critical thinking skills to ensure deliverables are accurate, easy-to-understand, and completed on time.</li><li>
Emphasizing the customer experience in the creation and coordination of all deliverables.</li></ul>
Coordinate content review requests for a variety of deliverables including letters, phone scripts, project deliverables, and more by:<ul><li>
Applying superior organization skills to keep track of work.</li><li>
Adjusting priorities as needed to deliver quality work on time.</li><li>
Using workflow management tools to gain efficiency and meet compliance requirements.</li></ul>
Skills:<ul><li>
Strong writing, editing, communication, and interpersonal skills. Ability to effectively communicate (verbally and in writing) among executive management and colleagues to resolve issues, differences of opinion, and to obtain accurate information to respond to customer requests.</li><li>
Takes initiative to quickly learn and translate complex principles, strategies, and information into consumer-friendly content.</li><li>
Strong project management and organizational skills. Ability to organize, develop, prioritize, execute, coordinate, manage, and guide the implementation of major projects.</li><li>
Process oriented with the ability to multi-task and shift priorities as needed to satisfy changing deadlines.</li><li>
Mastery of rules of proper grammar and punctuation.</li><li>
Detail oriented with strong editing and critical thinking skills to ensure clear, concise, and accurate deliverables in simple, uniform language that enhances the customer experience.</li><li>
Willingness to take on a variety of tasks to support others in the Marketing department.</li><li>
Strong PC skills, particularly in using Microsoft Word, PowerPoint, Excel, and workflow management. Willingness to learn new software and processes as needed.</li></ul>
Knowledge:<ul><li>
Proficiency in using multiple software platforms (including Microsoft Word, Excel, and workflow management systems), familiarity with various writing styles, and competency with document editing.</li></ul>
Experience:<ul><li>
Minimum of three to five years of progressive experience in written communications. Health insurance background is a plus.</li></ul>
Education, Certification, and Licenses:<ul><li>
A bachelor&rsquo;s degree preferably in communications, journalism, or English.</li></ul><div>
Location:</div><div><ul><li>
This position is classified hybrid, which requires onsite work on Tuesdays and Wednesdays.</li></ul></div>
Work Environment<ul><li>
Hybrid (office setting and home office).</li><li>
Fast-paced environment that requires flexibility and adaptability; ability to perform job assignments independently; and ability to adapt to a changing work environment, workload requirements, and working/reporting relationships.</li></ul>
Physical Demands:<ul><li>
While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see.</li><li>
The employee must be able to work over 40 hours per week.</li><li>
The employee must occasionally lift and/or move up to 5 pounds.</li></ul>
About Us: We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a caring team of supportive colleagues and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you&rsquo;ll help us live our mission of improving the health and well-being of our members and the communities in which they live.</div>

Communications Specialist

<div>Position Description:
<div>
Base pay is influenced by several factors including a candidate&rsquo;s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market-driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental &amp; Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more.</div><div>
At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it&rsquo;s why our employees consistently vote us one of the &ldquo;Best Places to Work in PA.&rdquo;</div> 
The CS Client Services Support Analyst is responsible to conduct research and provide problem-solving support to the Customer Service Department, Brokers and Sales serving the Small, Large and Major Market Groups as well as our Individual Account plans. Technical and administrative support as well as serving as a liaison to the Vendor contacts in regards to our plan benefits and policy issues. Responsible for reviewing, identifying and analyzing policies, procedures and contract issues that impact both departmental and/or Plan wide functions/operations. Prepare recommendations on all issues; root cause, action steps and monthly reports. This position is responsible for providing efficient, courteous, professional quality service to Groups, Plan personnel and Brokers/Sales in a timely manner. Inquiries are received via Internet, E-Mail and Internal Facets Routing Queues. Ensures compliance with organizational and regulatory requirements. Topics pertaining to enrollment, billing, benefits, and claims for various types of coverage offered by Capital BlueCross- Traditional, POS, PPO, HMO and Medicare Supplemental Programs. Knowledge of Medicare, PPACA, Healthy PA, CHIP, prescription, dental, vision, Chiropractic, Disease Management, Benefits Management, and other programs administered/supported by Capital BlueCross and Avalon.
Responsibilities and Qualifications:
<ul><li>20% - Researches and reviews customer inquiries as related to one of our Vendor LOB. Determines appropriate action by reviewing and interpreting applicable policies/procedures that are within the established regulatory requirements. Utilizes the PC, manuals, online reference materials, Imaging, etc., to obtain benefits, enrollment and claim information.</li><li>
20% - Ensures the satisfactory resolution of routine and complex Vendor inquiries including, but not limited to, benefits, claim filing and processing, collection issues, enrollment discrepancies, legal requests, Medicare Secondary Payer, Plus Billing and payment requests, Third Party Administrators, COBRA, reinstatements, conversions, refunds, new enrollment, transfer situations, student certifications, handicapped dependents, for all lines of business administered and supported by Capital BlueCross and Avalon. Conducts specific job related instructional sessions as requested by Supervisor.</li><li>
15% - Be able to prioritize work, communicate and share information with the team as necessary. Respond to customers inquiries via telephone, correspondence, on-site, Fax, Secure IT, E-mail and personal interviews from individual customers, group administrators, providers, Capital BlueCross personnel, Host Plan personnel, attorneys, and outside entities working on the customer's behalf.</li><li>
10% - Monitors Vendor related inquiries utilizing various system generated reports for accurate and timely resolution to ensure customer satisfaction and compliance with MTM (Member Touchpoint Measures), PPACA, ERISA, and Act 68 quality, and timeliness guidelines.</li><li>
10% - Provides clear and concise instructions to the appropriate Plan area, in the approved format (e.g., electronic, on-line or hard copy forms, telephone contact) for the resolution of the issues.</li><li>
5% - Contacts the appropriate internal/external entities (e.g., groups, providers, Marketing, Legal, Host Plans, Vendor contacts etc.) to obtain information and initiate necessary action.</li><li>
5% - Enters all information necessary to update the Facets inquiries, Sales Force Case, or Work Desk when appropriate, for tracking inquiry/Sales Force activity and keep notes updated on progress through resolution. Utilizes the system to obtain background information and prevent duplication of effort.</li><li>
5% - Report trends to management that may indicate processing problems, lack of documentation or appropriate information concerning claims, enrollment areas, benefits, policies and procedures.</li><li>
5% - Assists/participates with Marketing personnel and the broker community in the support of customer needs by researching and communicating information to other Company personnel or directly to the customer. May attend or participate in marketing related activities as a representative of Capital BlueCross (e.g., open enrollment, on-site visits, etc.).</li><li>
5% - Performance standards, business metrics and process improvements to include:@@Complete ongoing training to stay abreast of product, service and policy changes@@Improve our quality of work on a daily basis by learning and employing new skills@@Recognize, document and alert the supervisor of trends in customer service inquiries@@Conduct yourself in a manner consistent with the values of the organization.</li></ul>
Skills:<ul><li>
Demonstrates ability to communicate effectively and professionally both verbally and in writing with all levels of internal/external personnel in order to respond to customer inquiries ranging from routine to complex and involving sensitive subject matter</li><li>
Demonstrates ability to understand and interpret detailed policies and procedures and to be able to apply them to various situations. This includes thorough understanding of CBC&rsquo;s responsibility to maintain privacy of Protected Health Information as required by the Health Insurance Portability and Accountability Act.</li><li>
Demonstrates ability to work independently, be flexible and react appropriately to changing job assignments and work environments.</li><li>
Demonstrates analytical, organizational, and problem solving skills in order to accurately and efficiently identify, analyze and respond to customer/provider inquiries, as well as identify and analyze trends and discrepancies.</li><li>
Familiar with, or ability to, operate a PC and associated software; Microsoft Word, Excel, etc., phone equipment, calculator, fax, copier, and other department required hardware.</li><li>
Demonstrated competency in Windows (Outlook, Word, Internet Explorer, Excel and PowerPoint), SharePoint, and Sales Force.</li><li>
Above average reading, writing and arithmetic skills required (reading/math comprehension)</li></ul>
Knowledge:<ul><li>
Knowledge of benefit programs administered and/or supported by Capital BlueCross. Includes Medicare Advantage, Medicare Part D and Medicare Supplemental Programs, Dental, Vision, Chiropractic, Prescription Drug, Benefits Management, and Disease Management.</li><li>
Knowledge of the PBM and Facets health plan administration processing systems as well as online files for determining enrollment, billing, and benefits. Knowledge of benefits administration policies, customer billing processes, claims processing and general procedures.</li><li>
Knowledge of ERISA, Act 68, and BCBSA MTM,PPACA, HIPAA quality and timeliness guidelines and standards to ensure they are consistently met or exceeded</li><li>
Knowledge of Account Administration regulations, policies and procedures pertaining to Capital BlueCross and transfer of enrollment information to all our vendors</li><li>
Knowledge of multiple online inquiry systems and coding structures of files to interpret data used in responding to inquiries and Sales Force cases.</li></ul>
Experience:<ul><li>
3 years customer service or correspondence experience or experience/training in a writing-intensive role is required.</li><li><ul><li>Experience with customer interaction preferred.</li></ul></li></ul>
Education and Certifications:<ul><li>
High School degree or equivalent.</li></ul>
Work Environment:
Sedentary work involving significant periods of sitting, talking, hearing, keying and performing repetitive motions.!!Work requires visual acuity to perform close inspection of written and computer generated documents as well as a PC monitor.!!Working environment includes typical office conditions.!!Flexible schedules, including nights and weekends, based on business needs.!!Lively and fast paced.
Physical Demands:
While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see. The employee must be able to work 37.5 hours per week. The employee must occasionally lift and/or move up to 5 pounds.
Other:<ul><li>
Facets, Bridges, Workflow, Share Point, Sales Force, Microsoft Office (Outlook, Word, Excel, PowerPoint, Internet) STARS, CAPS, check reconciliation, Clarity, Business Object, Swift view, delegated administration, RadMD, Blue 2 and Work Desk. The PBM systems. CMS systems.</li><li>
Some travel into the office on weekends may be required for training sessions.</li></ul>
About Us: We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a caring team of supportive colleagues and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you&rsquo;ll help us live our mission of improving the health and well-being of our members and the communities in which they live.</div>

Client Services Support Analyst

Join Capital Blue Cross and explore 2   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Capital Blue Cross

ABOUT_COMPANY

Communications Specialist

Client Services Support Analyst