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Position Description

Arkansas Blue Cross and Blue Shield - EXEMPT POSITION DESCRIPTION

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Position:  Supervisor Model Office
Reports To: 
Division:  Customer Accounts (0002)
Company:  ABCBS
Location:  Label
Job Code:  039516
Min Salary:   50000
Date:  1/15/2013

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Position Specific Requirements: None


Job Summary
This position is accountable for coordinating and defining systems issues and activities as they relate to membership, billing and financial activity for the MemBRS® System. This includes evaluating system needs, identifying and designing enhancements, maintaining Data Definitions and the Common Tables/Valid Values updates in MemBRS, and controlling the security for the user profile access within the MemBRS® system. This position directs 4 Membership Analysts in a model office environment for testing MemBRS® System processing, developing test criteria for system modifications, documenting results and providing ongoing training to the operating areas within the Enterprise. Additionally, this position is responsible for coordinating all assigned activities, special projects, report development, and assisting in training required to ensure the effective implementation of changes and/or modifications to the MemBRS® System in addition to heavy support of the daily processing activities of the Customer Accounts Division. Updating and testing the Disaster Recovery Plan for Customer Accounts is an ongoing assignment. The Supervisor of the Model Office interacts closely with Information Systems staff in the testing and resolution of system related issues. The incumbent is also responsible for directing staff toward and participating in the ongoing maintenance of our vendor relationship with Benefitfocus.com, the provider of our BluesEnroll web enrollment tool, eBilling System, eExchange service bureau function, and all other Benefitfocus products that are used in the Enterprise. Special projects often include contact with employer groups and their enrollment vendors, in addition to Enterprise vendors such as Bank of America, Argus, and UCCI.

Nature & Scope
Environment

This position is a function of the Customer Accounts Division and reports to the Manager, Customer Accounts. The Supervisor of the Model office works closely with the operating divisions utilizing the MemBRS® System and the Information Systems staff to ensure appropriate system functionality is presented to support all membership, billing and financial activity. The incumbent is responsible for the supervision of a model office to provide complete system testing of the MemBRS® System and to support legacy system testing. The incumbent is responsible for assisting the Customer Accounts supervisory staff in developing procedures, documenting system errors, assessing training needs and considering possible system enhancements to improve processes. This position interacts with outside vendors/partners not only when frequently required in the completion of special projects and trouble-shooting involving membership transactions, but also in an ongoing production basis as it relates to the products provided by Benefitfocus.com.


Workflow

The incumbent receives work assignments from the Manager of Customer Accounts. Additionally, this position responds to e-mails and telephone inquiries from external parties, operating areas within the Enterprise, and Information Systems staff relating to all aspects of the MemBRS® System and legacy system interfaces. This position also responds directly to the Life Company, the VP or staff of Individual Services, and managers of other areas in fulfilling information and reporting requests. The work is ongoing and consists of research, testing, problem resolution and consultation with technical staff.


Guidance

This position receives guidance from the Manager of Customer Accounts. Guidance is also in the form of Enterprise Management and Customer Accounts policies relating to enrollment, underwriting and financial processing.


Challenges

The significant challenges of this position include:

1. Coordinating the testing of all enhancements to the MemBRS® System to ensure processing needs are met for membership and all legacy system interfaces.

2. Identifying and documenting necessary modifications and establishing test criteria necessary to evaluate functionality of the MemBRS® System to satisfy current and future processing needs.

3. Performing testing on the MemBRS® System, analyzing test results and communicating the results to the Manager of Customer Accounts.

4. Communicating in a clear, concise manner and providing professional and technical assistance to Information Systems personnel and supervisory or management staff of Customer Accounts.

5. Maintaining the proper test environment and adequate staffing levels in a model office setting to assure maximum efficiency and effectiveness are being realized within the test environment.

6. Directing a competent staff for testing and maintaining accurate personnel records, including performance evaluations for all employees supervised.

7. Assumes a key role in special projects such as coordinating testing for New Business for Individual and Group products, Individual Business rate increases, ASE/PSE re-enrollments, and enrollment automation initiatives.

8. Attending and participating in meetings as directed by the Manager of Customer Accounts and other managers or VPs as requested.

9. Responsible for researching and recommending solutions to processing problems related to membership, billing and financial activities.

10. Participating in ongoing communications with the vendor, Benefitfocus.com, as it relates to maximizing the use of the vendor’s products and resolving production issues that arise in our file transfer and other processes.


Interfaces

The incumbent interfaces with the following contacts on a regular basis:

Cashiers, Customer Accounts - to provide support and assistance in resolving issues relating to financial processing or direct billing.

Group and Individual Accounts - to provide support and assistance in resolving Customer Accounts issues relating to group billing and reconciliation.

ID Services/Customer Accounts - to provide assistance with ID Card issues.

Regular Business Support - to establish test data for support of GCPS testing.

Corporate Accounting - to provide information relating to financial processing through the MemBRS® System.

Actuarial Staff - to provide coordination of rate increase files.

Information Systems Staff - to monitor and report MemBRS® System problems and develop resolutions through
research and testing.

Technology Infrastructure - to establish and monitor security profiles for MemBRS® System user access.

Project Managers - to coordinate the membership portion of various special projects.

Regional Offices - respond to requests for information to satisfy Of Individual Services & Internal management needs.


Operations

Outside Vendors - to assist in installation of new membership capabilities and processes.

Benefitfocus Corporation - to direct staff and participate in the maintenance of our vendor/client relationship and the related production processes.


Authority

This position has the authority to research MemBRS® System problems and document Problem Resolution Requests when appropriate. The incumbent has the authority to develop test situations to support problem resolution, provide sign off for system modifications, developing improvements to existing processes establishing procedures for existing processes and controlling system access through MemBRS® user profiles. Additionally, the Supervisor of the Model Office has the authority to handle all personnel matters and prepare performance evaluations for the Model Office exempt staff.



Skills, Knowledge & Abilities

1. Demonstrated ability to motivate staff.

2. Demonstrated ability to work through conflicts.

3. Demonstrated ability to mentor/coach team members.



Minimum Job Requirements

1.  Must meet at least one of the following:

  •  A. High school diploma with experience as a Customer Accounts  Membership Specialist and currently at a Grade 11 or above.
  •  B. High school diploma with specialized customer service experience (non-food service) or claims processing or related experience in a hospital business office, medical provider's office or other health insurance company functioning in a lead role. (Grade 11 or above)
  • C. High school diploma or equivalent with supervisory experience in a professional business environment (non-food service).

2.  Experience utilizing Microsoft Word and excel.


3.  Good presentation skills, presentation may be required at interview.


4.  Must have an overall rating of ‘more than acceptable' on most recent performance appraisals with the same rating applying to Adaptability/Rapport, Interpersonal Skills, and Communication Skills.


5.  Must currently be exceeding all division standards.


6.  Successful completion of an approved Individual Development Plan.

7.  All applicants must complete the Supervisory Assessment Center.


Security Requirements
This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.

Segregation of Duties
Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.

PRINCIPAL ACTIVITIES OR ACCOUNTABILITIES (Essential Functions of Job)
1. Strong interpersonal skills.

2. Ability to communicate effectively on all levels, both orally and in writing.

3. Ability to identify/research problems and develop viable solutions.

4. Ability to make decisions based on facts or experience and assume the responsibility for those decisions.

5. Ability to analyze a special project or new product and coordinate necessary testing.

6. Ability to provide effective supervision and training for employees within the section.

7. A thorough knowledge of membership system requirements and ability to develop monitoring and control mechanisms for these requirements.

8. Ability to work with the Information Systems staff in the testing of enhancements to the MemBRS® System, and to understand and communicate on a technical level.

9. Ability to work independently and function with a minimum of supervision.

10. Knowledge of the Customer Accounts Division and major functions of other Divisions of the Enterprise.

11. Ability to provide training to Enterprise operating areas, as requested, on an individual basis or to groups of individuals.

12. Personal Computer experience.

13. Ability to define and request ad hoc reporting to support problem research, analysis and resolution.

14. Ability to plan, organize, monitor and conduct post installation review of assigned projects.

15. Ability to conduct meetings effectively.



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