Clinical Support Representative

Blue Cross and Blue Shield of Vermont is looking for a Clinical Support Representative to join our Utilization Management team. Our company culture is built on an unwavering focus on our members and giving them the best service possible. We offer a balanced, flexible workplace, an onsite gym, fitness and wellness programs, a competitive salary and full benefits package including medical and dental insurance, vision, 401k, paid time off and holidays, tuition reimbursement and student loan repayment, dependent caregiver benefits, and resources to support your ongoing personal and professional growth and development.

REMOTE WORK: Blue Cross has transitioned to a hybrid workplace where employees within driving distance of our Berlin, VT office work Wednesdays in the office with flexibility to work remotely the rest of the week.

Clinical Support Representative Responsibilities:

• Complete a training program comprised of mentoring and on-the-job training that provides the Representative with the technical knowledge, analytical, and Customer Service skills needed to accurately process prior authorizations and other authorizations and requirements.
• Provide accurate, prompt, and courteous responses to phone and written inquiries and to consistently provide outstanding customer service. Examples of such inquiries include, but are not limited to prior authorization questions and requirements, authorization issues such as requests or status checks, and initiating next steps for denied authorizations, underwriting guidelines, and internal policies and procedures.
• Contribute to excellent customer satisfaction by providing information and initiating appropriate corrective actions to resolve inquiries based on a comprehensive understanding of BCBSVT contracts, policies, systems, and procedures.

Clinical Support Representative Qualifications:

• High school graduate or equivalent required.
• Analytical and critical thinking skills required.
• Computer literacy and strong typing and spelling skills required.
• One to two years of successful customer service experience, preferably in a health insurance or health care setting is desired.
• The ability to multitask, problem solve, and work independently is necessary.

Clinical Support Representative Benefits:

• Health insurance (including vision)
• Dental coverage (free to employees)
• Wellness Program
• 401(k) with employer match + automatic employer contribution
• Life Insurance
• Disability Insurance
• Combined time off (CTO) – 20 days per year + 10 paid holidays
• Tuition Reimbursement
• Student Loan Repayment
• Dependent Caregiver Benefits