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Service Representative - PPO

Service Representative - PPO
Job ID: 14375


Position Objective
Responsible to provide accurate and timely customer service functions and claims processing for all professional/institutional group members. Responsible to assist and educate all members and providers of Special Account groups; research, analyze and resolve all inquiries requiring investigation; promote a favorable image of Blue Cross Blue Shield of North Dakota (BCBSND) by demonstrating shared business values to those who contact Member Services.


In-depth understanding of all benefit plans/products within the specialized service units
In-depth knowledge of inquiry/research screens/hard copy reference manuals
In-depth on-line Correspondence tracking system
ACD/Callwise phone system
Benefit matrix
In-depth knowledge of multiple computer systems/applications
In-depth claims processing knowledge
Medical terminology
ICD-9/CPT-IV coding
Understanding of national/departmental standards
In-depth knowledge of underwriting/membership guidelines
Basic computer knowledge

Strong customer service skills/phone etiquette skills
Excellent verbal and written communication skills
Effective listening skills
Ability to operate ACD/Callwise telephone system
Excellent comprehension, retention and problem solving skills
Interpret guidelines and reference manuals
Strong research/investigation skills
Excellent time management/organizational skills
Ability to prioritize workloads
Handle multiple tasks simultaneously
Flexible and adaptable
Ability to work with limited supervision and under pressure
Team player -- work well in group setting
Excellent interpersonal skills/conflict resolution
Data entry skills (alpha and numeric)
Behavior/actions that support Corporate Business Values

Education and/or Experience
High school degree or GED
1-2 years customer service experience including telephone,
medical background desired.

Equal Employment Opportunity
Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individuals with Disabilities

How To Apply
If you are interested in this job opening, please complete an application.

Note: All job openings require a completed application in order to be considered in the employment process.

If you are an individual who is unable to access our online application to apply, please contact Human Resources.

Primary Employment Representative: Talia Nelson
Phone Number: (701) 277-2330


Featured Employer Information
BlueCross BlueShield of ND
4510 13th Avenue SW
Fargo ND 58121
Talia Nelson
(701) 277-2330