Call Center Service Associate

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 Provide excellent service to customers through the resolution of basic customer inquiries received by phone or though written correspondence. What You'll Do Responsibilities: 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 Bring Education/Experience: High School Diploma/GED required Some experience in a call center or customer service role within the health insurance industry preferred. Knowledge: Medical terminology and medical billing coding preferred Skills and Abilities: Excellent Customer Service skills including the ability to manage and diffuse irate calls Ability to work in a high pressure, fast pace environment Keyboarding proficiency PC proficiency Strong verbal and written communication Interpersonal skills (i.e. active listening) Investigative and analytical skills Ability to multitask Time management skills Flexibility and adaptability Ability 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…