Call Center Service Associate

Horizon-Blue-Cross-Blue-Shield-of-New-Jersey; Hopewell (NJ); On-site; USD 48,000 - 64,000; Full time

Benefits offered by this job

Health benefits

Retirement plans

Paid time off

Incentive programs

Wellness programs

Volunteer time off

Tuition reimbursement

Job summary

Horizon Blue Cross Blue Shield of New Jersey seeks a Customer Service Representative to provide excellent service to customers through phone, fax, mail, or email. You will verify information and initiate investigations as needed to resolve claims, enrollment, or benefits questions.

The role requires precise documentation, timely follow-up, and adherence to quality standards while maintaining a positive member experience.

Qualifications

• High School Diploma or GED required.
• Some experience in a call center or customer service in health insurance preferred.
• Knowledge of medical terminology and medical billing coding preferred.

Responsibilities

• Provide excellent service to customers via phone, fax, mail, email.
• Verify information and initiate investigation based on inquiry.
• Document inquiries and actions following quality guidelines.
• Follow up on unresolved issues and escalate trends.
• Deliver a high-quality customer service experience while meeting standards.
• Perform other tasks as assigned.

Skills

Customer service

Verbal communication

Written communication

Interpersonal skills

Multitasking

Time management

Teamwork

Keyboarding

PC proficiency

Analytical skills

Education

High School Diploma/GED

Job description

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.About the RoleProvide excellent service to customers through the resolution of basic customer inquiries received by phone or though written correspondence.What You'll DoResponsibilities:Receive customer inquiries via phone, fax, mail, e-mail, etc. If necessary, probe for additional helpful information (i.e. member ID, claim number, name, etc.) in order to effectively handle inquiry.Review computer systems and/or other reference materials to complete verification process.Initiate investigation process based on the nature of the inquiry (claim, member information, benefits, enrollment, appeals, etc.).Utilize available resources to quickly and efficiently resolve or redirect inquiries in accordance with prescribed departmental process.Accurately document customer inquiries and actions taken in accordance with departmental quality guidelines to ensure appropriate follow up.Follow up on unresolved issues in a timely manner, escalating call trends to management.Deliver an excellent customer service experience while meeting quality and production standards.Perform other relevant tasks as assigned by management.What You BringEducation/Experience:High School Diploma/GED requiredSome experience in a call center or customer service role within the health insurance industry preferred.Knowledge:Medical terminology and medical billing coding preferredSkills and Abilities:Excellent Customer Service skills including the ability to manage and diffuse irate callsAbility to work in a high pressure, fast pace environmentKeyboarding proficiencyPC proficiencyStrong verbal and written communicationInterpersonal skills (i.e. active listening)Investigative and analytical skillsAbility to multitaskTime management skillsFlexibility and adaptabilityAbility to work effectively within a team environment*The employer may require an employee to pass a test(s) as part of determining whether the applicant meets the minimum qualifications for the job.Why Horizon?At Horizon, you’ll do meaningful work that directly improves lives—while being supported by a mission‑driven organization that values expertise, collaboration, and growth. We believe that when our people thrive, our communities do too. If you are passionate about making an impact, we’d love to hear from you!Salary Range:$47,961 - $63,820This 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 PlansGenerous PTOIncentive PlansWellness ProgramsPaid Volunteer Time OffTuition ReimbursementDisclaimer:Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware. 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.