Get to know us!
Florida Blue, a GuideWell Company, has been providing insurance to residents of Florida for 75 years. Driven by its mission of helping people and communities achieve better health, the company serves more than five million healthcare members across the state.
We are looking for exceptional people who will bring our mission to life and succeed by putting the member first. Friendly and outgoing sales-centered individuals that are passionate about helping others achieve their healthcare goals!

What is your impact:
The purpose of the Strategic Provider Service (SPS)/Plan-to-Plan (P2P) Service Advocate (SA) is to provide service at the advanced knowledge level to Strategic Providers and Sister Plans. SA is expected to handle inbound and outbound telephone calls regarding relationships with plans/providers and can handle inquiries end-to-end including any adjustments or rekeys that may be required.

What are your responsibilities:
Resolve all inbound telephone inquiries at all levels for SPS providers/BCBS plans for BlueCard Host, Home and Local claims and inquiries
Establish and maintain outbound schedule/relationship as needed with SPS provider to resolve SPS provider inquires. Initiate outbound calls with Blue Plans to resolve issues, obtain status and initiate the escalation process
Complete BlueCard Host, Home and Local adjustments/key claims as needed to resolve the provider's/member's issues
Facilitate weekly calls with hospital executives that include detailed discussions regarding claims processing and status of outstanding issues Prepare executive communications for coordination with BlueCard Executives
Perform analysis to determine root cause of issues and escalate to leadership as appropriate
Resolve inquiries received by the BlueCard Executives and serve as a point of contact for Inventory Management issues with other BCBS Plans
Handle complex issues received from the BlueCard PCC (Inbound and Outbound), National Sales and Marketing, Network Operations, Critical Inquires or National Strategic Accounts and facilitate resolution with the Home /Host Plan

What is required:
• 2+ years related work experience healthcare experience and/or healthcare billing
• Intermediate knowledge level Microsoft Office
• High School Diploma or GED

What is preferred:
• 3+ years related work experience in BlueCard or Local lines of business including customer service, adjustments and held claim functions
• BlueCard or Local lines of business including customer service experience
• In-depth understanding of InterPlan Policy and Processing Guidelines

General Physical Demands:
Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally.

What We Offer

As a Florida Blue employee, you will thrive in our Be Well, Work Well, GuideWell culture where being well as an individual, and working well as a team, are both important in serving our members and communities.

To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to:
• Medical, dental, vision, life, and global travel health insurance.
• Income protection benefits: life insurance, Short- and long-term disability programs.
• Leave programs to support personal circumstances.
• Retirement Savings Plan includes employer contribution and employer match.
• Paid time off, volunteer time off, and 11 holidays
• Additional voluntary benefits available and a comprehensive wellness programs
Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for intern, part-time and seasonal employees may differ.
To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for base pay increases.

Targeted Annualized Hourly Pay Range: $17.98 - $22.40
Annualized Salary Pay Range: $17.98 - $29.13

Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring.

We are an Equal Opportunity/Protected Veteran/Disabled Employer committed to creating a diverse, inclusive, and equitable culture for our employees and communities.