POSITION SUMMARY
The position responds to diverse and complex inquiries from customers in person and by telephone. The incumbent requires extensive knowledge of all of the company’s products and administrative practices relating to company procedures. Superior customer service skills are required.
DUTIES AND RESPONSIBILITIES
- Responds to a variety of customer inquiries ranging from:
- Enrollment and billing procedures
- Claims procedures and claims payments
- Coverage information
- Plan specific inquiries related to Ambulance/Hospital, Extended Health , Travel , Dental , Health Spending Account and Vision Care
- Confirms coverage, explains benefits and checks for processed claims for dental offices, hospitals, pharmacies, and various other health providers.
- Accurately completes an inquiry ticket for each call received and accurately completes forms and memos.
- Arranges Bonds of Indemnity for lost or stolen cheques, distributes explanation(s) of benefits, processes or forwards requests for address changes and identification cards for members to the appropriate department.
- Promotes and sells Travel Health products.
- Assists members with registration and navigation of the online portal.
- Accepts and forwards customer suggestions and complaints about all aspects of Blue Cross, including billing and enrollment, claims, products and/or benefits.
- Forwards possible leads for group health business to the Sales department.
- Forwards possible leads for individual health business to the Individual Products team.
- Remains current and knowledgeable about benefits which are provided by the Provincial Health Care Plan, particularly in respect to prescription drugs, travel health and vision care.
- Prepares for and deals effectively with customers who contact our office following radio programs, newspaper articles, mass mailings, etc.
- Assists the Customer Service Centre with in-person inquiries as required.
- Assists with replying to customer emails if required.
- Assists in directing customers to the appropriate source (i.e.: Government Agency) when the information does not pertain to Blue Cross.
- Assists Travel Agents and General Agents in selling, extending and refunding Travel Health, Trip/Holiday Cancellation and the Tour Package Plan as well as explaining coverage information and claims procedures.
- Maintains an awareness of changes to employer group plans in order to respond to customer inquiries.
- Performs other duties as assigned.
SKILLS & QUALIFICATIONS
- Dedicated to the principles of exceptional service; committed to responding to, anticipating and addressing customer needs, for both internal and external customers.
- University degree or Community College diploma in Business Administration or equivalent combination of education and related experience.
- Exceptional interpersonal and communication skills (verbal and written).
- Effective listening skills.
- Excellent organizational skills with the ability to work quickly and accurately under pressure of time restraints.
- Flexibility, patience and resourcefulness.
- Ability to handle pressure.
- Good computer skills including Word, Excel and e-mail software.
- Initiative and ability to work independently as well as in a team setting.
- Excellent problem solving and analytical ability.
- Several years’ experience dealing with the public.
- 2 - 5 years previous work experience in the insurance/customer service industry would be an asset.
- A second language would be an asset.
We offer competitive salary, modified benefits, a flex work hybrid schedule after training, and a health and wellness program with an on-site fitness centre. We are committed to creating a rewarding environment to foster learning and development for our staff. If you are interested in joining our team, please forward a resume and cover letter, indicating salary expectations, by April 27, 2023.
