A Healthcare Customer Service Representative responds to customer inquiries about healthcare and provides information about healthcare plans, providers, policies and coverage. Assists customers with questions about healthcare insurance and premiums. Keeps records of customer communications and transactions.
Remote Sr. Call Center Service Assoc Horizon Blue Cross Blue Shield of Jersey tuition reimbursement United States, Jersey, Hopewell Jul 20, 2026 Horizon Blue Cross Blue Shield of Jersey empowers our members to achieve their best health. For over 90 years, we have been 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 Resolve complex customer inquiries received by phone or though written correspondence. Provide excellent service to customers. Coach and mentor junior staff members.
What You'll Do Responsibilities:
Receive escalated customer inquiries and provide second level resolution by initiating or continuing investigation process, utilizing available resources and accurately documenting customer inquiry and actions taken in accordance with departmental quality guidelines.
Follow up on unresolved high priority/complex issues to ensure they are brought to conclusion in a timely manner.
Serve as a liaison for key internal and external operational contacts to ensure that an optimal level of service is provided to customers.
May assist in monitoring and managing team-s call volume and inventory including tracking and trending key customer service issues and reporting them 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
18 months+ call center/customer service experience required
Health insurance industry experience required.
Knowledge:
Medical terminology and medical billing coding required
Knowledge of multiple claims systems preferred
Skills and Abilities:
Excellent Customer Service skills
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)
Strong investigative and analytical skills
Ability to multitask
Ability to manage and diffuse irate calls
Time management skills
Flexibility and adaptability •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 missiondriven 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 to hear from you!
Salary Range:
$52,787 - $70,172 This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes: Comprehensive health benefits (Medical/Dental/Vision)
Retirement Plans Generous PTO Incentive Plans Wellness Programs Paid Volunteer Time Off Tuition Reimbursement Disclaimer:
Horizon BCBSNJ employees must live in Jersey, York, Pennsylvania, Connecticut or Delaware. Horizon Blue Cross Blue Shield of Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.