Account Services Representative - Premier, Senior

At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. We're excited to share Blue Shield of California has received awards and recognition for - LGBT diversity, quality improvement, most influential women in corporate America, Bay Area's top companies in volunteering & giving, and one of the world's most ethical companies. Here at Blue Shield of California, we're striving to make a positive change across our industry and the communities we live in - Join us!


Job Summary

The Account Services Representative will be reporting to the Labor and Trust Senior Director and is responsible for and in partnership with an Account Manager, while building relationships to maintain members, growing membership within companies during open enrollment, and developing strategies to increase member loyalty. Serves as a liaison between employers-brokers-consultants and the internal operations staff for the plan; communicating benefits, providing claims cost reports and experience rating exhibits. Also services the account on a day-to-day basis for issues regarding billing, claims, and eligibility.

  • Can tailor value proposition during open enrollment / client meetings based on their specific value drivers using solid understanding of BSC products. How they work and how they compare to competitors.
  • Uses thorough understanding of upcoming developments in the healthcare market (healthcare reform, state and local healthcare legislation, new entrants, customer need shifts). Understands how they may impact competitor's benefit offering and member eligibility.
  • Facilitates open enrollment / admin / health fair meetings.
  • Anticipates client and member questions and can provide in-depth responses.
  • Groomed to participate finalist presentation and develop health fair experiences.
  • Maintains robust stakeholder relationship. Builds strong relationships with client's internal operations staff (e.g. HR) Leverages available BSC information (i.e. wellness flyers, other marketing materials) for meetings. Proactively follows up with stakeholders.
  • Clients are cognizant of "go to" BSC contacts for billing, claims and service process queries.
  • Secures high participation rates from client survey feedback after administering open enrollment meetings.
  • Appropriately leverages available resources to complete back-office tasks and solve problems. Thoroughly understands BSC tools and systems, effectively addresses system issues with manual work (if applicable).
  • Has effective working relationships with other functional groups. Basic understanding of how to escalate issues, drive the process along and when to update the Account Manager.
  • Develops relationships with contacts in other departments. Leverages relationships to move processes along.


Knowledge and Experience
  • Bachelor's degree and typically 4 plus years related experience, preferably in sales, marketing or health plan administration or equivalent combination of education and experience and sales management experience.
  • In-depth knowledge of the health care industry and related benefit products and services.
  • ASO contract knowledge.
  • Familiarity with case installation process.
  • Current Life Agent License with California Department of Insurance preferred, and valid California driver's license and proof of insurance is required.

Physical Requirements

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.
Please click here for further physical requirement detail.

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.EEO Policy