Cust Care Rep I 34291 Me 8-11 Ps
WellPoint (Southern/Portland, Maine)

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WellPoint is the nation's leading health benefits company serving the needs of approximately 28 million medical members nationwide. Anthem Blue Cross and Blue Shield, a proud member of the WellPoint family of companies, is currently seeking Customer Care Representatives. At Anthem, we are dedicated to our mission of improving the health of the people we serve. We believe the best healthcare coverage can actually help people stay healthy.  Bring your expertise to our innovative, performance-focused culture, and you will discover lasting rewards and the opportunity to take your career further than you can imagine.   Customer Care Representative I South Portland, Maine Starting Salary:  $27,000.00 Monday - Friday, 8:00a.m. to 5p.m.        The position begins with paid training on AUGUST 11, 2008  Monday through Friday, between 8:00am and 5:00pm for 8-12 weeks. FULL ATTENDANCE IS REQUIRED.     Job Description Functions on a learning curve to become fully proficient in all aspects of customer service, claims and/or membership issue resolution. Performs research and analysis, advocating on behalf of customers through whole case methods. Learns to provide full service to providers, group administrators, brokers, and members by processing health care claims, handling inquiries, and/or performing membership functions. Performs at least two of the three functions routinely. Essential duties to include, but are not limited to:  Receives inbound telephone calls or paper and electronic claims from members and providers. Resolves issues for members, providers, group administrators and brokers.   Analyzes the situation and completes research to ensure no rework or follow-up issues. Applies knowledge of policies and procedures, products, legislation and claims workflow. Interacts with systems to ensure claims are paid or denied based on terms of contract. Initiates interaction with other areas to ensure claims are handled properly and thoroughly. Interprets claims to determine primary or secondary liability and recognize when additional information is needed.   Makes decisions on claims payment while considering benefit status, provider status, and impact on Wellpoint, the provider and the member.   Performs other duties as assigned. Training to start August 11, 2008 Requirement: To be considered for this position a customer service on-line assessment is required. This can be taken from any PC that has Internet access and is free of charge, however, it is not provided at an Anthem site. You will be contacted via email.  Please check your email regularly as testing and other notifications are sent to your email address and will require your prompt attention. Required 8-12 weeks full attendance in paid training to begin on August 11, 2008 High School diploma or GED and three to six months experience in an automated customer service environment or equivalent combination of formal education and relevant experience. Basic computing and keyboarding skills including proficiency with database management. Strong attention to detail to accurately enter data and research and resolve questions. Strong verbal communication skills including active listening; uses basic written communication skills to record client activity in database.