Customer Service Representative II

<strong>With more than 8,000 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. Interested in joining us?</strong>

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.&nbsp;

keywords: analysis,performance,compliance,organization,communication,support,research,reporting,education,performance,claims,training,experience,communication,support,knowledge


Competitive Total Compensation Package

Overview: <strong><span style="font-size: small;">Evaluates, and resolves inquiries involving a variety of claim, benefit, membership, and/or billing inquiries. Must be able to pass the Customer Service selection process, in order to interview.</span></strong>
Responsibilities: <ul> <li><span style="font-size: small;">Conducts internal and external research to determine and request the data needed to handle inquiries from internal and external business partners.</span></li> <li><span style="font-size: small;">Provides accurate and timely servicing responses via telephone, and/or written correspondence to our internal and external customers.</span></li> <li><span style="font-size: small;">Follows department/corporate reporting policies and procedures requirements.</span></li> <li><span style="font-size: small;">Organizes work to meet productivity and quality standards.</span></li> <li><span style="font-size: small;">Reroutes misdirected inquiries.</span></li> <li><span style="font-size: small;">Interacts with others inside and outside the organization to resolve the inquiry/claim related problems.</span></li> <li><span style="font-size: small;">Resolves customer inquiries through clear and simple explanations of the applicable policy and/or procedure.</span></li> <li><span style="font-size: small;">May assist less experienced Customer Service Representatives and handle unusual or urgent inquiries, including irate calls.</span></li> <li><span style="font-size: small;">Perform other related duties as assigned.</span></li> </ul>
Requirements: <ul> <li><span style="font-size: small;">High school graduate or GED equivalent is required.</span></li> <li><span style="font-size: small;">Two (2) years of related work experience in areas such as public/customer service, sales representatives claims processing, membership/billing/enrollment; and one (1) year of customer service experience in positions such as teaching, social service work, bank teller, medical assistant/office assistant, retail.</span></li> <li><span style="font-size: small;">Three (3) years of total related experience or in the absence of internal BCBSM experience, the following may apply: A total of three (3) years of related work experience in areas such as public/customer service, sales representative, claims processing, enrollment/membership, or billing processing. Eighteen (18) months as an Account Clerk IV in Group Billing/Direct Billed/Auto National Membership and Support Departments.</span></li> <li><span style="font-size: small;">Demonstrated knowledge of policies, practices and procedures related to membership, billing, contract coverage or changes, rating and eligibility requirements, and/or claims processing.</span></li> <li><span style="font-size: small;">Demonstrated ability to resolve inquiries related to benefits, claims processing, and/or membership/billing, with little or no assistance.</span></li> <li><span style="font-size: small;">Demonstrated command of all oral, written, and interpersonal skills necessary for communications with subscribers, beneficiaries, accounts or providers, in a clear, concise and tactful manner.</span></li> <li><span style="font-size: small;">Work experience requirements may be modified within the three (3) year total, to fit individual unit needs. Must be able to pass the Customer Service selection process.</span></li> <li><span style="font-size: small;">Employees shall meet a twenty-four (24) month tenure requirement, excluding training.</span></li> <li><span style="font-size: small;">Other related skills and/or abilities may be required to perform this job.</span></li> </ul>