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Blue Cross Blue Shield of Massachusetts Omni-Channel Business Expert in Hingham, Massachusetts

Ready to help us transform healthcare? Bring your true colors to blue.

The Omni-Channel Business Expert supports MAPS and the larger organization with a variety of member inquiries and complaints as they filter in through less standard channels. The largest of which is supporting our Account Service team by handling member-related Sales inquiries that come into the MS Hub via Salesforce. The Omni-Channel Business Expert also supports several different email boxes and helps respond to organic member social media messages in a timely manner. The Omni-Channel Business Expert is responsible for resolving escalated member issues that are triaged to the team via senior leaders and other areas of the business in which a service recovery or member outreach is needed. The Omni-Channel Business Expert works collaboratively with many different areas across the business including HMM, Digital Marketing, Network Management, amongst many others. In addition to this work, the Omni-Channel Business Expert also provides direct support to the Omni-Channel team within MAPS. The Business Expert is responsible for providing guided coaching and sharing knowledge on products and workflows to help representatives field a variety of member inquiries via Live Chat and Contact Us (email). The Business Expert acts as a consultant to the Omni-Channel team by sharing best practices and tips, confident messaging, and efficiency methods to better assist our members. Business Experts help support our collective efforts to track and trend and find opportunities for process improvement. The Business Expert plays an integral role in helping the department meet all its goals such as First Call Resolution and providing high quality service to our members. This role reports directly to the Manager of the Omni-Channel and Integrated Service Solutions Lines team within the Business Operations business unit within MAPS.

Responsibilities:

  • Research, respond, and resolve member inquiries in a timely manner by partnering with the Account Service team by working Sales cases sent to our team via Salesforce in the MS Hub.

  • Manage inventory of the MS Hub in Salesforce to ensure turnaround time goals are met.

  • Monitor email boxes and answer questions from broker(s) related to claims inquiries on behalf of our members.

  • Assist in the monitoring of inbound social media messages through Sprinklr and engage on Member Service specific related inquiries to bring about clarification and resolution.

  • Take ownership of highly escalated and sensitive member issues as directed by senior leaders and on behalf of other areas that require member outreach.

  • Answer complex questions and help resolve issues that require Member Service input in order to better assist other areas within the business.

  • Monitor, react, and respond to member emails sent to the generic Member Service email box to help escalate urgent Contact Us responses and misrouted member emails in a timely manner.

  • Complete member outreach requests to facilitate misdirected member questions or messages on behalf of other business areas.

  • Act as a consultant and coach to Omni-Channel representatives asking for support to help resolve member inquiries.

  • Take elevated member issue chats from representatives on the Omni-Channel team as needed.

  • Contribute to a culture of service excellence by motivating and inspiring representatives to anticipate customer needs, proactively prevent future problems, take ownership, and resolve issues in a timely manner.

  • Make decisions and accurately respond to elevated member issues and inquiries through effective research and thorough analysis.

  • Effectively manage follow up and respond to members in a timely manner to avoid future escalations.

  • Communicate key information and Omni-Channel trends to leadership and make recommendations for process improvements.

  • Establish and maintain positive relationships and effective communications with internal and external customers.

  • Provide coaching and mentoring opportunities to Omni-Channel representatives.

  • Demonstrate service center awareness and initiative by monitoring Live Chat precision queues and reacting with appropriate urgency to ensure the Omni-Channel team is properly staffed to handle chat volume.

  • Help identify knowledge gaps and training needs of staff to leadership.

  • Assist in improving and creating job aids as needed based on research trends, product, and account issues.

  • Assist in managing Contact Us inventory and maintaining the Member Service email box to ensure timely follow through and execution.

  • Participate in projects and workgroups as needed.

  • Support Omni-Channel functions such as Live Chat and Contact Us as needed.

  • Must adhere to assigned schedule to ensure proper coverage.

  • Meet all metric requirements.

Qualifications:

  • Excellent organizational and time management skills.

  • Excellent communication skills both written and verbal.

  • Strong analytical skills with ability to pay attention to detail.

  • Strong critical-thinking skills with the ability to “think outside the box” to creatively solve problems.

  • Ability to multi-task and juggle many different tasks, priorities, systems, and applications at once.

  • Ability to communicate effectively on written, electronic channels including email, chat, and social media.

  • Personal commitment to high quality through integrity, accountability, compassion, and teamwork.

  • Proven track record of building and maintaining solid relationships with members, peers, leaders, and business partners.

  • Demonstrated flexibility and willingness to adapt as business needs change within the organization.

  • Excellent interpersonal skills with ability to work both within a team and independently to meet business objectives.

  • Proven ability to provide coaching and feedback.

  • Self-starter able to take ownership to resolve issues in a timely manner in a fast paced, high-volume environment.

  • Vast knowledge of products, policies, and procedures that can be called upon quickly and accurately.

  • Ability to remain calm under pressure while maintaining a patient and professional tone.

  • Ability to work a flexible schedule that includes later shifts as business needs dictate.

  • Positive attitude and commitment to trust and respect while working with our members, providers, and fellow colleagues.

  • Team oriented and mission driven.

  • Comprehensive knowledge of BlueView, Mainframe (RTMS & NASCO), and all Member Service workflows.

Education & Training:

  • BS/BA degree preferred or equivalent work experience

  • 2+ years’ experience working in an operations or customer service environment

  • Leadership experience preferred

Minimum Education Requirements:

High school degree or equivalent required unless otherwise noted above

LocationHingham, QuincyTime TypeFull time

At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. We provide a flexible hybrid work model in which roles are designated as resident (on site 4-5 days/week), mobile (on site 1-3 days/week), or eworker (on site 0-3 days/month).

Blue Cross Blue Shield of Massachusetts, has a COVID-19 vaccination requirement for building entry. Your offer of employment is dependent upon either being fully vaccinated for COVID-19 or an accommodation based on a disability or sincerely held religious belief, practice, or observance by submitting a request to Human Resources.

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