Customer Service Representative I

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.

Detroit, 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.<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 />Learn more about your options as an external candidate. <a href="" target="_blank" rel="noopener noreferrer">Click here</a> to view open positions.

keywords: analysis,organization,analysis,consulting,research,skills,education,experience,knowledge


Competitive Compensation and Benefits Package

Overview: Analyzes, evaluates, resolves and primarily responds to low complexity level membership issues under various product lines.&nbsp;
Responsibilities: <ul> <li><span style="font-size: small;">Primarily conducts low complexity internal and external research to determine and request the data needed to handle inquiries regarding membership.&nbsp;</span></li> <li><span style="font-size: small;">Analyze and service various product lines in the area (i.e., Facility, Professional).&nbsp; Provide responses by telephone, check-off letters, and/or automated letters.</span></li> <li><span style="font-size: small;">Follow department/corporate reporting requirements (i.e., PCRS, ICS, Special Surveys and Manual counts).&nbsp;</span></li> <li><span style="font-size: small;">Organize work to meet National/Corporate/Department Production and Quality Standards.&nbsp;</span></li> <li><span style="font-size: small;">Reroute misdirected inquiries.&nbsp;</span></li> <li><span style="font-size: small;">Primarily evaluates membership issues/inquiries and price/adjudicates low complexity claims/inquiries.&nbsp;</span></li> <li><span style="font-size: small;">Interact with others inside and outside the organization to resolve the inquiry/claim-related problems.&nbsp;</span></li> <li><span style="font-size: small;">Influence customers to accept the reasonableness of decisions and actions.&nbsp;</span></li> <li><span style="font-size: small;">Other duties may be assigned.</span></li> </ul>
Requirements: <ul> <li><span style="font-size: small;">High school graduate or GED equivalent.</span></li> <li><span style="font-size: small;">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.</span></li> <li><span style="font-size: small;">One (1) year of total related experience or in the absence of internal BCBSM experience, the following may apply:&nbsp; One (1) year of related work experience in areas such as public/customer service, sales representative or claims processing.</span></li> <li><span style="font-size: small;">Demonstrated knowledge of policies, practices and procedures related to membership.</span></li> <li><span style="font-size: small;">Demonstrated ability to analyze data and resolve problems related to membership.</span></li> <li><span style="font-size: small;">Demonstrated command of all skills necessary for oral and written communications in a clear, concise and tactful manner.&nbsp;</span></li> </ul>