Adjudication, Analysis Skills, Bidding, Claims Processing, Communication Skills, Community and Social Services, Customer Support/Service, Customer/Client Research, Data Analysis, High School Diploma, Medical Office Administration, Medicare, Presentation/Verbal Skills, Problem Solving Skills, Quality Metrics, Sales, Training/Teaching, Writing Skills
Customer Service Rep I
Full-time
Shift: 8:00 am to 5:30 pm
(Shift bidding process based on seniority)
(Both training and position will be based out of the Detroit location)
Assessment required- Customer Service Rep
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. Commercial, Medicare, Provider, etc.). Provide responses by telephone, email, chat, check-off letters, and/or automated letters.
- Follow department/corporate reporting requirements.
- 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.
QUALIFICATIONS
- 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. In the absence of BCBSM experience, (1) year of public contact in positions such as teaching, social service work, bank teller, medical or office assistant.
- 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.
B
Blue Cross and Blue Shield Association
At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry. We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.
2,000 to 2,499 employees
https://www.bcbs.com/about-us/careers