Pricer VII State Wide Call In

With more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust.

Grand Rapids, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.&nbsp;<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />For Application Timeline &amp; Selection Process:&nbsp;<a href="" target="_blank" rel="noopener noreferrer">Click Here</a>. Learn more about your options as an external candidate. <a href="" target="_blank" title="BCBSM" rel="noopener noreferrer">Click here</a> to view open positions.

keywords: position summary,communication,performance,claims,analysis,research,notify,skills,experience,education,communication,analysis


Competitive Total Compensation Package

Overview: <p>Responsible for adjustment processing of claims received via telephone or written inquiry from internal customers.</p>
Responsibilities: <ul> <li>Handle telephone inquiries generated from all internal customer and provider servicing areas and adjust claims as appropriate based on the nature of the call.</li> <li>Contact internal and external resources via phone or written communication for additional information required to process claim payments.</li> <li>Complete written inquiries generated from all corporate customer and provider servicing areas and adjust claims as appropriate based on worksheet instructions.</li> <li>Research and recommend solutions to expedite aged claims for payment or closure utilizing internal and external systems.</li> <li>Finalize pricing edits for all claim types.</li> <li>Notify leadership of system problems or possible fraud situations.</li> <li>Perform other related duties as assigned.</li> </ul>
Requirements: <ul> <li>High school graduate or GED equivalent is required.</li> <li>Two (2) years of previous call center experience. Claim processing experience preferred.</li> <li>Verbal and written communication skills required to obtain information and prepare correspondence.</li> <li>Math skills required to calculate payment amounts and adjustments.</li> <li>Analytical skills necessary for benefit interpretation and application.</li> <li>Other related skills and/or abilities may be required to perform this job.</li> <li>Other related skills and/or abilities may be required to perform this job.</li> </ul> <div id="gtx-trans" style="position: absolute; left: -36px; top: 26px;">&nbsp;</div>