Provider Network File Technician I-III - REMOTE AZ

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Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:

  • Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week
  • Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week
  • Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month
  • Onsite: daily onsite requirement based on the essential functions of the job
  • Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building
Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week. This remote work opportunity requires residency, and work to be performed, within the State of Arizona.

PURPOSE OF THE JOB

  • Responsible for updating, maintaining and researching a variety of provider file information in multiple systems

QUALIFICATIONS

REQUIRED QUALIFICATIONS

Required Work Experience

  • 1 year of experience in general business field (level 1)
  • 3 years of experience in general business field (level 2)
  • 5 years of experience in general business field (levels 3 and 4)
Required Education
  • High-School Diploma or GED in general field of study
Required Licenses
  • N/A
Required Certifications
  • N/A
PREFERRED QUALIFICATIONS

Preferred Work Experience

  • 2 year(s) of experience in health insurance field
Preferred Education
  • Associate's Degree in general field of study
Preferred Licenses
  • N/A
Preferred Certifications
  • N/A

ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES

  • Responsible for updating and maintaining the applicable provider file database(s) with documentation submitted.
  • Responsible for provider contract file research and to recommend appropriate actions and/or maintenance.
  • Responsible for researching and resolving provider file claims edits.
  • Analyze reports for any data corrections and processes for the Association.
  • Responsible for the review of the provider files for Quality Control.
  • Each progressive level includes the ability to perform the essential functions of any lower levels.
  • The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
  • Perform all other duties as assigned.

COMPETENCIES

REQUIRED COMPETENCIES

Required Job Skills

  • Intermediate PC proficiency (Applies to All Levels)
  • Intermediate skill in use of office equipment, including copiers, fax machines, scanners and telephones (Applies to All Levels)
  • Intermediate level skill in word processing, spreadsheet and database software (Applies to All Levels)
Required Professional Competencies
  • Maintain confidentiality and privacy (Applies to All Levels)
  • Ability to interpret and translate policies, procedures and guidelines (Applies to All Levels)
  • Ability to follow and accept instruction and direction (Applies to All Levels)
  • Establish and maintain working relationships in a collaborative team enviroment (Applies to All Levels)
  • Ability to navigate, gather, input and maintain data records in multiple system applications with applicable accuracy (Applies to All Levels)
  • Ability to work independently (Applies to Levels 2 – 4)
  • Ability to problem solve (Applies to Levels 2 - 4)
  • Ability to provide fair and accurate quality reviews (Applies to Levels 3 & 4)
  • Ability to handle projects with minimal supervision (Applies to Levels 3 & 4)
  • Ability to handle high volumes of work with additional responsibility for cross functional duties (Applies to Level 4)
Required Leadership Experience and Competencies
  • Ability to made decisions related to provider file processes & explain information clearly. (Applies to Levels 3 & 4)
  • Ability to train, mentor and guide co-workers. (Applies to Levels 3 & 4)
  • Ability to distribute work to lower levels (Applies to Level 4)
  • Ability to handle escalated/expedited issues to resolution (Applies to Level 4)
  • Ability to interpret and make decisions based on available reporting (Applies to Level 4)
  • Ability to cover for Management when needed & represent the department (Applies to Level 4)
PREFERRED COMPETENCIES

Preferred Job Skills

  • N/A
Preferred Professional Competencies
  • N/A
Preferred Leadership Experience and Competencies
  • N/A
Our Commitment AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.

Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...