Hybrid Account Services Representative - Premier, Senior bei Blue Shield of California
Blue Shield of California · Los Angeles, Vereinigte Staaten Von Amerika · Hybrid
- Professional
- Optionales Büro in Los Angeles
Your Role
The Premier Accounts team manages all group business with 3,000 or more employees, with nearly 6 million total members. Our strategy to win in the market is to understand and meet the needs of commercial/national public-sector employers, labor trusts, and their consultants in a way that exceeds their expectations by providing easy, understandable interactions and affordable choices through efficient use of premium dollars to establish Blue Shield as the preferred choice in health plans. Reporting to the Manager, Account Management Services, you will be an integral part of the account management team assigned to a Premier account Book of Business. In your Book of Business there will be one account that will be 60% of your workload. You may be required to go to their offices 3 to 4 times a week, this client resides in the city of Los Angeles. You will lead client servicing on a day-to-day basis and are responsible for communicating benefits, advancing issue resolution for multiple departments including but not limited to billing, claims and eligibility and supporting customer reporting with key informational updates to the account team.
Responsibilities
Your Work
In this role, you will:
- Facilitate open enrollment/client meetings and tailor value proposition based on their specific value drivers using solid understanding of BSC products
- Facilitate open enrollment/admin/health fair meetings and provide in-depth responses to member questions; groomed to participate in finalist presentation and develop health fair experiences
- Maintain robust stakeholder relationships and build strong relationships with clients’ internal operations staff (e.g. HR/Benefits staff)
- Leverage available BSC information (i.e. wellness flyers, other marketing materials) for meetings and proactively follow up with stakeholders
- Demonstrate a clear and organized method of tracking client issues including maintaining agendas and meeting notes for regular client check-in calls; support requests, pull, review and distribution of client reports
- Be primarily responsible for all administrative functions of renewing groups annually, i.e. benefits review, required documentation review (SBCs/EOCs/SPDs/benefit booklets/etc.) and group order paperwork
- Attend internal compliance, network update meetings and review network announcements, market communications, breach announcements and communicate updates and impact to account teams
- Maintain a good understanding of upcoming developments in the healthcare market (healthcare reform, state and local healthcare legislation, new entrants, customer need shifts) and understand how they may impact competitor’s benefit offerings and member eligibility
- Anticipate client questions and provide in-depth responses for meetings on the same day or next day service level agreements, and effectively train clients on specific billing, claims and service process
- Work collaboratively with internal functional groups including but not limited to: Installation and Billing, Eligibility, Data Analytics, Underwriting, Marketing, Medical Care Solutions and others
Qualifications
Your Knowledge and Experience
- Requires a bachelor's degree or equivalent experience
- Requires at least 4 years of prior relevant experience
- Requires a current Life Agent License with the California Department of Insurance; or the ability to obtain one within the first 90 days of employment to maintain employment, a valid California driver's license, proof of insurance, and reliable transportation
- Requires knowledge and experience of the health insurance industry and related benefit products and services including billing, claims, and eligibility, with a proven track record in providing account servicing to large, multi-sited customers of 3,000 employees and larger and an understanding of unique requirements of alternative funding arrangements, including self-funding
- Requires willingness to travel and attend health fairs and client meetings state and nationwide as needed (potentially between 25% to 35%)
- Requires experience presenting both in person and virtual to important stake holders and members
- Requires candidate to live in Southern California
About Company
About Blue Shield of California
As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.
At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.
Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!
Our Values:
- Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
- Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
- Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
Our Workplace Model:
At Blue Shield of California and the Ascendiun Family of Companies, we believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility. As we continue to evolve our workplace model, our focus remains on creating spaces where our people can connect with purpose – whether working in the office or through a hybrid approach – by providing clear expectations while respecting the diverse needs of our workforce.
Two Ways of Working:
- Hybrid (Default): Work from a business unit-approved office at least two (2) times per month (for roles below Director-level) or once per week (for Director-level roles and above). Exceptions:
o Member-facing and approved out-of-state roles remain remote.
o Employees living more than 50 miles from their assigned offices are expected to work with their managers on a plan for periodic office visits.
o For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.
- On-Site: Work from a business unit-approved office an average of four (4) or more days a week.
Physical Requirements:
Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.
Please click here for further physical requirement detail.
Equal Employment Opportunity:
External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
