Durham jobs to be affected by Blue Cross outsourcing

May. 13, 2014 @ 02:34 PM

Blue Cross and Blue Shield of North Carolina plans to cut about 125 claims jobs, many in Durham, starting in 18 months.

They’ll trim another 125 positions through attrition.

The cuts loom as the company plans to outsource most of its claims work to Accenture.

“Much of the claims process is done electronically,” said Lew Borman, a spokesman for Blue Cross and Blue Shield of North Carolina. “It’s something that can be accomplished in other ways and companies like Accenture do that as a business, and do it efficiently, and do it cost effectively.”

The insurer employs about 375 people for claims-related work, Borman said. He said the company expects to keep a third, or about 125, of those jobs. The rest will be eliminated through attrition and job cuts.

In large part, he said, the insurer’s claims employees work in offices in Durham, although some are in Chapel Hill.

“We’ve made the decision, and we want to get that out, and we’re discussing it with the employees so they can make plans,” Borman said. “Again, we anticipate that some will be retained, others may find positions in the company, but there’s counseling … support available.”

Borman said most of the outsourced claims work involves lower-level claims that go through the system in a “more orderly way.”

However, the insurer plans to continue handling complex claims and those requiring medical review in-house. Borman said that work involves review of complex and high-dollar claims.

The insurer also will keep claims work in-house for the State Health Plan of North Carolina, the insurer’s Federal Employee Plan, which is also known as the Federal Employee Health Benefits Program, and for Medicare products.

The insurer also announced on Tuesday that it’s planning to open a new regional service center in Fayetteville by the end of the year to take customer calls. The new center is expected to employ more than 100 people by mid-2015. The insurer has existing service centers in Durham and in Winston-Salem.

“Our goal is to focus our talented, in-house workforce on more complex work where they can solve problems and touch customers more directly,” said Alan Hughes, the insurer’s executive vice president and chief operation officer, in a statement. “Our employees are second-to-none when it comes to interactions with our customers and other complex functions. By shifting the more automated work of preparing claims for processing to an outside vendor, we can maintain a sharper focus on these key areas.”