Senior Principal Claims Clerk

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.

• Ensures mail is sliced and distributed daily.
• Distribute incoming mail to staff for workflow purposes and timely processing.
• Utilize computer to perform administrative clerical functions to fulfill customer needs.
• Perform clerical duties which include photocopying and filing.
• Handle priority mail including accurate distribution to the appropriate areas, including interoffice, fax, and e-track.
• Assist with daily reporting, may include recording and reporting receipt volumes on all incoming mail and faxes.
• Ensures timely data entry of written appeals, inquiries and e-tracks into their respective databases.
• May interact with claim vendor and provides necessary reports.
• Perform other related duties as required by Management.

Core Individual Contributor Competencies:

• Personal and professional attributes that are critical to successful performance for Individual Contributors:
• Customer Focus
• Accountable
• Learn
• Communicate

Education/Experience:

• Requires High School Diploma or GED equivalent.
• Requires one (1) year clerical business experience preferably in a customer service environment.
• Prefers one (1) year working in a production environment or health insurance industry.

Knowledge:

• Requires strong working knowledge of personal computers and supporting software in a Windows-based environment including MS Office Products and email application systems.

Skills and Abilities:

• Requires the ability to quickly and accurately perceive and classify detailed information, to be determined by the Visual Speed and Accuracy Test (UV).
• Requires the ability to classify information, to be determined by the Classifying Test (US).
• Requires the ability to read, understand, interpret and follow written direction - to be determined by the Written Direction Test (UW).
• Requires the ability to apply reason in order to determine the appropriate arithmetical operation for solving a problem, to be determined by problem Solving Test (UP).
• Ability to learn and apply knowledge quickly
• Flexibility/Adaptability
• Organization
• Multitasking
• Analytical Thinking
• Interpersonal
• Presentation
• Pace
• Structure
• Independence
• Efficient
• In certain divisions, may require the ability to lift materials approximately twenty (20) to fifty (50) pounds.

Work Hours: 7:30 am- 4:00 pm M-F

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law.

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware

Salary Range:

This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:

• Comprehensive health benefits (Medical/Dental/Vision)

• Retirement Plans

• Generous PTO

• Incentive Plans

• Wellness Programs

• Paid Volunteer Time Off

• Tuition Reimbursement

Disclaimer:
This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.