Sr. Call Center Service Assoc

100 Horizon Healthcare Services, Inc; Hopewell (NJ); On-site; USD 52,787 - 70,172; Full time

Benefits offered by this job

Comprehensive health benefits

Retirement Plans

Generous PTO

Incentive Plans

Wellness Programs

Paid Volunteer Time Off

Tuition Reimbursement

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking a customer service specialist to resolve complex inquiries by phone or written correspondence. You’ll coach junior staff, ensure high-quality service, and support operational goals.

The role requires a high school diploma or GED, 18 months+ call center experience, and knowledge of medical terminology and medical billing coding. Health insurance industry experience is preferred, with strong communication and multitasking skills.

Qualifications

• High school diploma or GED required.
• 18+ months of call center or customer service experience required.
• Health insurance industry experience preferred; knowledge of medical terminology and billing codes strongly desired.

Responsibilities

• Receive escalated customer inquiries and provide second level resolution by initiating or continuing investigation and documenting actions.
• Follow up on unresolved high priority/complex issues to ensure timely conclusion.
• Serve as a liaison for internal and external operational contacts to ensure optimal service levels.
• May assist in monitoring and managing team call volume and inventory and report key issues to management.
• Deliver an excellent customer service experience while meeting quality and production standards.

Skills

Excellent customer service

Strong verbal and written comms

Interpersonal skills

Time management

Multitask

Ability to diffuse irate calls

Keyboarding proficiency

Education

High School Diploma/GED

Tools

Claims systems

Medical billing systems

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 Role

Resolve complex customer inquiries received by phone or though written correspondence. Provide excellent service to customers. Coach and mentor junior staff members.

Responsibilities

• Receive escalated customer inquiries and provide second level resolution by initiating or continuing investigation process, utilizing available resources and accurately documenting customer inquiry and actions taken in accordance with departmental quality guidelines.
• Follow up on unresolved high priority/complex issues to ensure they are brought to conclusion in a timely manner.
• Serve as a liaison for key internal and external operational contacts to ensure that an optimal level of service is provided to customers.
• May assist in monitoring and managing team‑s call volume and inventory including tracking and trending key customer service issues and reporting them to management.
• Deliver an excellent customer service experience while meeting quality and production standards.
• Perform other relevant tasks as assigned by management.

Education / Experience

• High School Diploma/GED required
• 18 months+ call center/customer service experience required
• Health insurance industry experience required.
• Knowledge: Medical terminology and medical billing coding required.
• Knowledge of multiple claims systems preferred.

Skills and Abilities

• Excellent Customer Service skills
• Ability to work in a high pressure, fast‑pace environment
• Keyboarding proficiency, PC proficiency
• Strong verbal and written communication
• Interpersonal skills (active listening)
• Strong investigative and analytical skills
• Ability to multitask
• Ability to manage and diffuse irate calls
• Time management skills
• Flexibility and adaptability

Compensation

Salary Range: $52,787 - $70,172. Compensation decisions are dependent on the circumstances of each case.

Benefits

• Comprehensive health benefits (Medical/Dental/Vision)
• Retirement Plans
• Generous PTO
• Incentive Plans
• Wellness Programs
• Paid Volunteer Time Off
• Tuition Reimbursement

Other Information

*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.

Equal Opportunity

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.