CSC Intake Specialist Job:
Blue Cross and Blue Shield of Minnesota

20465-en_US
Blue Cross and Blue Shield of Minnesota
Eagan Minnesota
Healthcare
Description

About Blue Cross



Founded in 1933, Blue Cross and Blue Shield of Minnesota is the largest health plan in the state. We have more members, the largest network of providers and more products and services than any other plan in Minnesota. From the beginning, Blue Cross has been an innovator with a mission of making a healthy difference in people’s lives.



We understand the importance of finding a job that you truly enjoy — at a company that shares your values. We’ve made it easy to feel good about working at Blue Cross by encouraging volunteerism, valuing diversity and offering the flexibility you need to live a balanced life. We offer a suite of comprehensive medical and dental benefits as well as competitive pay, flexible work schedules and generous personal paid time off in addition to 20 hours of volunteer paid time off each year. We look forward to serving Minnesotans over the next 80 years and beyond. Join us and make a healthy difference through the work you do every day.


Description Summary

This position is responsible for performing the initial determination of incoming requests, initial system setup, gathering of appropriate case information and distribution of cases to Liaison.

Accountabilities


  1. Perform initial review of incoming receipts to assess the next steps.

  2. Determine the appeal reason, service category, and the appropriate team to handle the appeal as well as identify priority for the case.

  3. Responsible for performing the initial interpretation of contracts and collecting of system data

  4. Enter the appeal/inquiry information into the appeal database.

  5. Identify trends with incoming appeals.

  6. Prepare and send the correct Acknowledgement Letter based on the type of business.

  7. Collaborate with internal business partners to research issues and assist in resolution of appeals.

  8. Complete assigned special projects that require research, analysis and documentation

  9. Interpret and summarize the initial concern received on correspondence.


Requirements


  • High School Diploma or equivalent.

  • Associates degree and 1 year experience in healthcare, insurance or other regulated service delivery industries or 3 years of relevant experience in lieu of degree.

  • Demonstrated ability to write clear, concise and grammatically correct materials with ability to express complex concepts in simple terms.

  • Excellent written communication skills with the ability to express complex concepts in lay terms.

  • Demonstrated skills in problem solving, and decision-making.

  • Prioritization skills in order to meet deadlines demonstrated ability.

  • Adaptable and flexible.

  • Possess initiative and ability to work independently and in a team environment.

  •  Proficient with multiple PC based software applications and systems.

  • Demonstrated ability to work independently and in a team environment.

  • Knowledge of state and/or federal regulatory policies and/or provider agreements, and a variety of health plan products.


Preferred Requirements


  • 1 year experience with any of BlueCross’ business systems (ex . membership, billing, customer service, medical).

  • Demonstrated ability to establish and maintain positive interpersonal relationships with co-workers and other departments.

  • Demonstrated ability in making timely and service oriented decisions.

  • Demonstrated ability to enhance or develop new skills in response to changing expectations.


FLSA Status

Non-Exempt

Make a difference



Thank you for your interest in Blue Cross. Be part of a company that lets you be you — and make a healthy difference in people’s lives every day



Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, or any other legally protected characteristic.



Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.

Basic Qualifications
Requirement