[Remote] Broker Contract Specialist II (Remote)

Note: The job is a remote job and is open to candidates in USA. CareFirst BlueCross BlueShield is a healthcare organization seeking a Broker Contract Specialist II to provide comprehensive support and communication to Brokers and Agencies. The role involves reviewing documentation for compliance, responding to inquiries, maintaining broker data, and supporting Broker Sales Representatives.

Responsibilities

• Review and analyze documentation submitted by Brokers, Agencies, GPs, and FSPs to determine the appropriate course of action. Ensure timely and accurate processing of credentialing, Broker of Record (BOR) transfers, Block Transfers, and Broker/Agency Agreements for Individual and Group business while maintaining compliance with departmental standards and regulatory requirements
• Provide professional, accurate, and timely responses to inquiries from internal and external customers. Utilize independent judgment, analytical skills, and critical thinking to research and resolve broker commission withholding issues, recognizing the financial impact of processing inaccuracies. Leverage proficiency in Microsoft Office applications, including Excel, Word, Outlook, and Teams, to support reporting, communication, documentation, and data analysis activities. Prepare written correspondence related to updates and transfers and maintain adherence to departmental Standard Operating Procedures (SOPs)
• Accurately enter and maintain broker data in Facets billing system to support tracking of BOR and Block Transfer activities. Onboard brokers and agencies by entering and maintaining the Broker/Agency Agreements and credential updates in Salesforce broker management system. Verify broker licenses and appointments across multiple state jurisdictions using state regulatory websites. Research and conduct audit review of broker data for credentialing requirements for Broker Accounting to ensure accurate processing of broker commissions
• Provide comprehensive support to Broker Sales Representatives regarding account-related issues. Respond to routine and ad hoc reporting requests to support BOR Transfers, Block Transfers, Broker/Agency Agreement processing, licensing, insurance verification, and appointment status activities. Serve as a point of contact for audit documentation requests and provide timely feedback upon completion of reviews. Follow established workflows and SOPs related to contracting, compliance, and transfer functions while coordinating effectively with internal and external partners
• Participate in conference calls and team meetings, contributing ideas and recommendations related to best practices, process improvements, and operational efficiencies. Ensure all contracting and BOR/Block Transfer documentation is accurately maintained within the shared drive. Provide issue resolution and support to external vendors by analyzing and resolving credentialing-related issues affecting withheld commissions and downstream system access

Skills

• High School Diploma or GED
• 3 years' customer service, client or broker communication and interaction experience
• Strong inter-personal and teaming skills
• High level analytical and statistical ability required to resolve spreadsheet report issues
• Strong organizational and time management skills; ability to work in a fast-paced environment
• Ability to interact effectively with people at different organizational levels, both internally and externally
• Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence
• Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging
• Must be eligible to work in the U.S. without Sponsorship
• 4 years in a customer service environment with experience in health insurance/managed care industry

Benefits

• CareFirst offers a comprehensive benefits package
• Various incentive programs/plans
• 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements)

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