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Blue cross blue shield careers remote

Remote, USA Full-time Posted 2025-04-16

We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we??ve built our reputation on over 80 years?? worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors??our members. If you??re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today!Learn more about our unique benefit offerings here.You can also learn more about working at Wellmark here.Job DescriptionAbout the Role: You will provide daily support to Wellmark care management team members through making outbound calls to clinical staff regarding denials for services and admissions, as well as scheduling peer to peer reviews for Medical Directors. In this role, you will complete prompt and professional outbound phone and fax inquiries to obtain member discharge dates. You will also request clinical information as directed by the Care Coordination Nurses. On occasion, you will also provide backup for other Health Services team membersAbout You: Are you excited about the opportunity to advocate for stakeholders through collaboration with multi-disciplinary teams? Are you able to manage a large variety of responsibilities while staying organized? Do you have a high attention to detail and are thorough in your work? If you are a dedicated, customer-focused health care professional motivated and inspired by the opportunity to provide administrative support to care management teams in a fast-paced environment, apply today!

This role will require training for the first 4 weeks from our Des Moines, Iowa office. After a successful training period, you will have the option to work remote every day, or a hybrid office/home schedule based on your preference. *

QualificationsRequired:

High School Diploma or GED.
1+ years of related experience in health insurance or health care industry experience with knowledge of health insurance terminology and medical coding, including the ability to translate jargon and abbreviations to medical language.
Experience producing medical reports, correspondence, records, patient care information, statistics, medical research and/or administrative material.
Strong written and verbal communication skills with the ability to communicate complex concepts clearly and concisely to stakeholders.
Proficiency with Microsoft Office applications.
Experience working in a team environment.
Experience establishing relationships and effectively engaging with members and providers by demonstrating active listening skills through telephonic communication to obtain necessary information.
Ability to work in a fast-paced environment where production and/or quality goals are measured.
Demonstrated commitment to timeliness, prioritization, accuracy, and attention to detail.

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