Associate Support Specialist

Pay Range:

Please emailif you are a candidate seeking a reasonable accommodation for the application and/or interview process.

At BCBSRI our greatest resource is our people.

We come from varying backgrounds different cultures and unique experiences. We are hard-working caring and creative individuals who collaborate support one another and grow together. Passion empathy and understanding are at the forefront of everything we donot just for our members but for our employees as well.

We recognize that to do your best work you have to be your best self.
Its why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health dental and vision insurance as well as programs that support your mental health and well-being. We pay competitively offer bonuses and investment plans and are committed to growing and developing our employees.

Our culture is one of belonging.
We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where youre at in the organization youre an integral part of our team and your input thoughts and ideas are valued.

Join others who value a workplace for all.
We appreciate and celebrate everything that makes us unique from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders.

Were dedicated to serving Rhode Islanders.
Our focus extends beyond providing access to high-quality affordable and equitable care. To further improve the health and well-being of our fellow Rhode Islanders we regularly roll up our sleeves and get to work (literally) in communities all across the statebuilding homes working in food pantries revitalizing community centers and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can our associates receive additional paid time to volunteer.

What you will do:

• Respond to inquiries from internal and external customers; facilitate problem resolution through research. Refer call to appropriate resources in a timely manner.
• Interact with clinical staff to obtain health care information necessary for data entry payment authorization or quality initiatives. Perform data entry into the medical information system and other applicable data bases.
• Prepare correspondence and survey information for clinical staff; ensure adherence to regulatory accreditation and departmental standards.
• Research claims and coverage data and verify eligibility for payment purposes.
• Prepare monthly and ad hoc reports to support operational needs of the division and other duties as assigned to support corporate objectives.
• Assist team with department initiatives and projects.
• Perform other duties as assigned.

What youll need to succeed:

• High school diploma
• Up to two years experience in a medical hospital or third party payer setting

The extras:

• Experience in claims
• Experience in a managed care environment
• Knowledge of state and federal health regulations and accreditation standards (e.g. NCQA URAC DOH DHS CMS)
• Working knowledge of medical terminology
• Computer navigation skills
• Written and verbal communications skills
• Time management skills
• Ability to collect and organize data
• Ability to work independently
• Ability to meet established time and quality standards
• Ability to exercise sound judgment

Location:
BCBSRI is headquartered in downtown Providence conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules based on role:

• In-office: onsite 5 days per week
• Hybrid: onsite 2-4 days per week
• Remote: onsite 0-1 days per week. Permitted to reside in the following states pending approval from the Human Resources Department: Arizona Connecticut Florida Georgia Louisiana Massachusetts North Carolina Oklahoma Rhode Island South Carolina Texas Virginia
  

Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do and it strengthens our ability to meet the challenges of todays healthcare industry. BCBSRI is an equal opportunity employer.

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