(FEP) Customer Service Representative

Your Role

Our FEP - (Federal Employee Program) Customer Experience Teams receive incoming telephone calls from healthcare providers and active and retired Federal Employees. Call Centers are open Monday-Friday from 8:00am to 4:30pm. This position is a hybrid remote position, not office based, which may require you to travel to the office a few times a year. If hired, you will be required to attend and complete a paid, 10 week mandatory training course. You must attend each day for 8 hours, totaling 40 hours per week for the required training period.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

The following job summary will help you understand the candidates/people well suited to our FEP Call Center Team environment.

Job Summary:

Projected Start date: October 2026

Mandatory Training: Hybrid

As a FEP Customer Care Representative (CCR), you oversee and uphold our mission of providing service worthy of our family and friends. Our members look to you to help them navigate healthcare, providing empathy and advocacy. You are tasked with ensuring that our member's current and next issue are resolved. FEP is a National Plan, so BSC members under the FEP PPO program have the same benefits in all states. This requires our agents (you) to support FEP members throughout the US and work with other plans to provide a seamless experience. You will provide direct support for professional services claims, and partner with (other agencies) Anthem to resolve member issues relating to facility claims.

Successful CCRs deliver an effortless customer experience by:

• Taking the lead - our CCRs take ownership of members'' issues, relieving members'' stress while guiding them to a quick and easy resolution.
• Identifying future problems - not only do our CCRs solve the current member concern but they actively identify and solve any lurking complications the member may encounter after their first interaction.
• Sharing insights with peers and management - our positive team culture relies on open communication to continuously improve how our work gets done.
• Having fun! - our work is important, but we don''t take ourselves too seriously. We love helping others and have a fun community dedicated to doing so!

You must also be:

• Available to work a scheduled 8-hour shift, which includes 2 scheduled breaks and a lunch period, also available to work an occasional holiday as part of your regularly scheduled shift
• Patient with members who call into our Centers with a question or a problem
• An active listener and not only answer the questions they ask you, but identify and answer questions the member may not be aware they needed
• Comfortable using a computer with 2 display monitors to allow you to navigate to multiple screens for information
• To multi-task using a computer; talking to the member, and entering member information into their online record

Your Knowledge and Experience

• Must reside in the state of CA preferably within a 50-mile radius from one of our office locations - Lodi, Rancho Cordova, Redding, Woodland Hills, Long Beach etc.
• Requires a High School Diploma or GED
• Typically, requires at least 3 years of prior relevant experience
• Requires attending and completing training facilitated remotely
• Requires basic job knowledge of Microsoft Suite systems and the ability to use applications on a computer proficiently
• Requires high internet connectivity speed of a minimum 11MBPS and 3 MBPS upload speed
• Requires private work location at their residence free from distractions and within 15 feet of their Wi-Fi modem

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.

Your Work

In this role, you will:

• Handle on a typical day an average of 30+ calls
• Resolve incoming calls concerning member''s eligibility, benefits, and provider information.
• Compose routine and non-routine correspondence to answer benefits/provider inquiries in writing
• Perform routine to mid-level inventory reduction (i.e., member inquiries, may initiate claim adjustments, respond to emails, etc.)
• Review and analyze member claims for accuracy as well as member education on how benefits are applied
• Participate in quality and efficiency workgroups to continuously improve quality member/customer satisfaction as requested
• Proactively analyze available programs and engage members with their wellness plan options
• Provide deductible and max out of pocket information
• Provide status of a prior authorization requests
• Assist members when and how to appeal a coverage decision

Your Work

In this role, you will:

• Handle on a typical day an average of 30+ calls
• Resolve incoming calls concerning member''s eligibility, benefits, and provider information.
• Compose routine and non-routine correspondence to answer benefits/provider inquiries in writing
• Perform routine to mid-level inventory reduction (i.e., member inquiries, may initiate claim adjustments, respond to emails, etc.)
• Review and analyze member claims for accuracy as well as member education on how benefits are applied
• Participate in quality and efficiency workgroups to continuously improve quality member/customer satisfaction as requested
• Proactively analyze available programs and engage members with their wellness plan options
• Provide deductible and max out of pocket information
• Provide status of a prior authorization requests
• Assist members when and how to appeal a coverage decision