Group Inquiry Rep

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.

Southfield, 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: departmental summary,analyze & evaluate,duties,departmental preferences,education,knowledge,departmental requirements


Competitive Total Compensation Package

Overview: <p>Non-Exempt/Bargaining Unit Posting</p> <p>Local/Seniority Unit &ndash; 1781/0000</p> <p>Date Posted Internal &ndash; 4/6/23, Deadline Date &ndash; 4/14/23</p> <p>Department &ndash;&nbsp;126540 BCN-Group Membership and Billing</p> <p>Salary Grade &ndash; UF</p> <p>Job Code - B2 C</p> <p>Number of openings &ndash; Multiple&nbsp;</p> <p>Shift &ndash; shift bidding process based on seniority</p> <p>Site/Location: BCN Commons</p> <p>Status &ndash; Regular Full Time<br /><br /><strong>Departmental Summary<br /><br /></strong>Interact directly with account/union personnel, account customers, other plans, other carriers, and agents to identify and resolve servicing issues. Analyze, research, and resolve problems and initiate corrective action to ensure retention of business. Analyze, research, and respond to sensitive/complex telephone, written, or walk-in inquiries. Coordinate efforts of BCBSM Group Account Management and BCN leadership persons to ensure uniform interpretation and application of HMO benefits.</p>
Responsibilities: <strong><strong>Departmental Preferences<br /><br /></strong></strong> <ul> <li>Analyze, evaluate, and respond to inquiries from employer groups, union reps, managing agents, agents, and BCN/BCBSM personnel. Document each contact on system. Update membership information following membership production guidelines (including, but not limited to, adds, terms, PCP changes, address changes, and ordering ID cards).</li> <li>Identify problems/discrepancies in interpretation and administration of membership guidelines, policies, procedures, benefits, and contract language. Recommend improvements to correct issues and communicate issues to Field Service Representatives for development of educational programs.</li> <li>Coordinate the resolution of inquiries that require input from other departments.</li> <li>Other duties as assigned by the Group Inquiry leadership team. Participate in corporate committees, and, at times, lead or facilitate work groups</li> </ul>
Requirements: <strong><strong>Departmental Requirements<br /><br />Qualifications</strong></strong> <ul> <li>High School or GED graduate required.</li> <li>Associates degree or two years of full-time college credits preferred. Degree in business, marketing, education, or health-related discipline preferred.</li> <li>Two (2) years responding to telephone and/or written inquiries in a call center environment required.</li> <li>Knowledge of BCN/BCBSM systems and operations preferred.</li> <li>Knowledge of customer service inquiry workflow and techniques required.</li> <li>Basic knowledge of Microsoft Word and Excel applications preferred.</li> <li>Demonstrated knowledge of health care policies, procedures, certificates, riders, and benefits as related to inquiry processing preferred.</li> <li>Knowledge of HMO/health insurance industry terminology preferred.</li> <li>Knowledge of NCQA and MTM guidelines and requirements preferred.</li> <li>Knowledge of call center telephone systems, call center operations, and imaging technology required</li> <li>Maintain Inventory Tracking database. Maintain Workforce Management Tools system for production control including the input of data and working of regular reports.</li> <li>Ability to manage multiple priorities and establish and maintain positive working relationships at all levels required.</li> <li>Professional servicing skills required.</li> <li>Excellent time management, analytical, and problem solving skills required.</li> <li>Excellent verbal/written communication skills, including excellent sentence structure, grammar, and punctuation required.</li> <li>Ability to tactfully negotiate at different levels required.</li> <li>Personal computing and typing skills required.</li> </ul>