Health Insurance Support Specialist

CareFirst BlueCross BlueShield; Baltimore (MD); On-site; USD 32,000 - 59,000; Full time

Job summary

CareFirst BlueCross BlueShield in Baltimore, MD seeks a customer service professional to handle member, provider, and broker inquiries in a call center setting. You will explain benefits, resolve claims, and assist with eligibility and billing questions while guiding users through digital self-service options.

The role emphasizes accuracy, empathy, and the ability to document interactions per policy. Frequent knowledge updates and ongoing training support service excellence.

Qualifications

• Demonstrated PC navigation and data entry skills.
• Strong interpersonal communication skills.
• Good oral and written communication skills.
• Ability to quickly gain customer trust and confidence.

Responsibilities

• Provides first- level problem resolution to member, provider & broker inquiries via telephone and/or written correspondence by gathering and researching information; examine claim submissions verifying claim and system accuracy as well as liability, validate customer understanding of information and resolves issues based on applicable policies and procedures.
• Uses knowledge of products and the contractual provisions that govern administration to provide customer service and education, to interpret contractual language to the customer for the purpose of providing benefit utilization and limitations, to determine the need for managed care initiatives, and to administer all types of services to customers within the business segment through telephonic inquiries, written and/or electronic inquiries and claims adjustments, if applicable. Appropriately documents all client interactions according to established departmental procedures.
• Delivers accurate information to customers in accordance with performance goals and objectives.
• Maintains customer records by updating account information by effectively utilizing the business areas enrollment/inquiry tracking system & processes.
• Participates in ongoing education related to new services, industry topics, and skills.

Skills

Empathetic communication

Interpersonal skills

Oral and written communication

Trust-building

PC navigation

Data entry

Customer service excellence

Education

High School Diploma or GED

Job description

CareFirst BlueCross BlueShield in Baltimore, MD seeks a customer service professional to handle member, provider, and broker inquiries in a call center setting. You will explain benefits, resolve claims, and assist with eligibility and billing questions while guiding users through digital self-service options.

The role emphasizes accuracy, empathy, and the ability to document interactions per policy. Frequent knowledge updates and ongoing training support service excellence.