Blue Cross Blue Shield of Michigan

About Blue Cross Blue Shield of Michigan

Analyzes, evaluates, resolves and primarily responds to low complexity level membership issues under various product lines. Primarily conducts low complexity internal and external research to determine and request the data needed to handle inquiries regarding membership. Analyze and service various product lines in the area (i.e., Facility, Professional). Provide responses by telephone, check-off letters, and/or automated letters. Follow department/corporate reporting requirements (i.e., PCRS, ICS, Special Surveys and Manual counts). Organize work to meet National/Corporate/Department Production and Quality Standards. Reroute misdirected inquiries. Primarily evaluates membership issues/inquiries and price/adjudicates low complexity claims/inquiries. Interact with others inside and outside the organization to resolve the inquiry/claim related problems. Influence customers to accept the reasonableness of decisions and actions. Other duties may be assigned. Qualifications Education and Experience High school graduate or GED equivalent. One (1) year of related work experience in areas such as public/customer service, sales representative, claims processing, membership enrollment or one (1) year of public contact in positions such as teaching, social service work, bank teller, medical assistant/office assistant. One (1) year of total related experience or in the absence of internal BCBSM experience, the following may apply: One (1) year of related work experience in areas such as public/customer service, sales representative or claims processing. Demonstrated knowledge of policies, practices and procedures related to membership. Demonstrated ability to analyze data and resolve problems related to membership. Demonstrated command of all skills necessary for oral and written communications in a clear, concise and tactful manner. All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, protected veteran status or status as an individual with a disability. Job Operations Primary Location Detroit Organization Service Operations-7103 Schedule Full-time ISMG - UJ - Non-Exempt - S407R

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Company Type: Nonprofit

Company Size: 5001 - 10000

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