Healthcare Ticket Resolution Specialist

4 weeks ago


Philadelphia, Pennsylvania, United States Independence Blue Cross Full time

At Independence Blue Cross, we are seeking a highly skilled and detail-oriented Issue Resolution Specialist to join our team. This critical role is responsible for receiving, investigating, and resolving State Based Exchange tickets in a timely and accurate manner.

Key Responsibilities:
  • Manage and monitor caseload daily to ensure tickets are researched, processed, and resolved accurately and timely.
  • Collaborate with operational departmental liaisons and other Issue Resolution Specialists to ensure accurate and timely resolution of SBE tickets.
  • Produce high-quality, comprehensive, and reader-friendly written responses that address all consumer concerns accurately and within required timeframes.
  • Expertly understand, navigate, and comply with SBEs and ACA regulations and guidance.
  • Identify root causes of SBE tickets and deficiencies in organizational processes, and share suggestions to enhance the organization's overall performance.
  • Provide regular status reports on all outstanding tickets and/or tasks.
  • Train and support fellow team members as needed.
Requirements:
  • Bachelor's Degree preferred.
  • 2-3 years of experience in the Healthcare industry.
  • Foundational knowledge of Billing, Accounts Receivable, Accounts Payable, Claims, Enrollment, Benefits, Cash Application, and Customer Service within the Healthcare industry.
  • Excellent research and investigative skills, strong interpersonal skills, and the ability to work effectively with all associate and management levels.
  • Strong critical-thinking and analytical skills, along with the ability to interpret and decipher complex information required.
  • Understanding of SBEs mandates and regulations related to the ACA business preferred.
  • Self-motivated, highly organized, detail-oriented, and above-average solving, verbal, and written communication skills are required.
  • Ability to effectively multi-task and prioritize.
  • Ability to thrive in a high-pace, continuously changing environment.
  • Proficient in Microsoft Excel, Access, Word, PowerPoint, and Outlook.

We are an equal opportunity employer and welcome applications from diverse candidates.



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