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Customer Service Rep I - MA Servicing (Detroit) C-S-R

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Detroit, MI

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JOB DETAILS
SKILLS
Adjudication, Analysis Skills, Call Centers, Claims Processing, Communication Skills, Community and Social Services, Customer Support/Service, Customer/Client Research, Data Analysis, High School Diploma, Medical Office Administration, Presentation/Verbal Skills, Problem Solving Skills, Quality Metrics, Sales, Training/Teaching, Writing Skills
LOCATION
Detroit, MI
POSTED
Today
Job Description

Customer Service Rep I
Full-time
Shift: 8:00 am to 5:00 pm
Detroit, MI
Assessment required- Customer Service Rep

Blue Cross Blue Shield of Michigan is looking for outgoing, energetic, phone friendly individuals to work in a fast-pace call center environment. The Customer Service Reps 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.
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; 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.

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