Customer Service Representative

Premera Blue Cross Spokane , WA 99201

Posted 2 weeks ago

Join Our Team: Do Meaningful Work and Improve People's Lives

Our purpose, to improve customers' lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.

To better serve our customers, we're creating a culture that promotes employee growth, collaborative innovation, and inspired leadership. We are committed to creating an environment where employees can do their best work and where best-in-class talent comes, stays, and thrives!

Job Summary:

The Customer Service Representative/Provider Representative provides inbound and/or outbound customer service support ensuring delivery of accurate, complete and timely information pertaining to member policies and coverage thoroughly documenting all calls. Conducts research to provide claims status, as well as investigates routine requests and escalates all call issues as required. Customer Service Reps serve both Premera members and providers. Provider Reps serve Premera's providers which includes doctors, facilities (clinics, hospitals, skilled nursing facilities, etc.), and vendors for multiple geographic locations.

What you will do:

Customer Service Representative

  • Accountable for inbound and/or outbound phone based customer service in the course of providing first call and/or email resolution, as well as caller education, through clear and accurate exchange of information.

  • Follow-up, resolve and document issues. Route inquiries needing further investigation to the appropriate department and conduct routine research as needed.

  • Follow up on pended items and route incoming paperwork to correct departments for completion.

  • Work with highly sensitive information while maintaining Personal Protected Information (PPI) requirements.

  • Other duties as assigned.

What you will bring:

Minimum Qualifications:

  • One (1) year previous customer service experience.

Preferred Qualifications:

  • Two (2) years of college level courses or two (2) years' work experience with phone related customer service

  • Healthcare, benefits, call center, claims processing or Facets experience

  • Bilingual proficiency in a particular language (English/Spanish) with the ability to articulate messages and information clearly and accurately

Knowledge, Skills and Abilities:

  • PC skills to include the ability to navigate and keyboard through a variety of systems.

  • Demonstrated positive tone of voice and empathy with caller while providing needed information in a timely manner.

  • Strong written and interpersonal communication skills with ability to articulate messages and information clearly and accurately.

  • Demonstrated ability to work in a structured/regulated and fast-paced environment with rigorous performance metrics.

  • Ability to multi-task, pay attention to detail, prioritize work and work independently.

  • Ability to understand and translate medical terms into plain language for our members and providers.

  • Demonstrated positive tone of voice and empathy with caller while providing needed information in a timely manner.

  • Knowledge and understanding of medical, pharmacy, and Blue Cross Blue Shield Association guidelines and policies.

Working Environment:

  • Work is performed within a normal call center office environment with ambient temperatures

  • Ability to work flexible work schedules when required

  • May require bilingual proficiency in a particular language (English/Spanish) with the ability to articulate messages and information clearly and accurately.

Physical Requirements:

The following have been identified as essential physical requirements of this job and must be performed with or without an accommodation:

This is primarily a sedentary role which requires the ability to exert up to 10 lbs. of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. This role requires the ability to keyboard, to communicate and to receive detailed information through verbal communication clearly and understandably in person, and over the telephone.

EOE - Equal Opportunity Employer. Minorities, women, veterans and individuals with disabilities are encouraged to apply.

What we offer

  • Medical, vision and dental coverage

  • Life and disability insurance

  • Retirement programs (401K employer match and pension plan)

  • Wellness incentives, onsite services, a discount program and more

  • Tuition assistance for undergraduate and graduate degrees

  • Generous Paid Time Off to reenergize

  • Free parking

Equal employment opportunity/affirmative action:

Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.

If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at or via phone at 425-918-4785.

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Customer Service Representative

Premera Blue Cross