Claims Support Specialist - Workers' Comp

Blue Cross Blue Shield of Michigan; Lansing (MI); On-site; USD 36,000 - 54,000; Full time

Job summary

Blue Cross Blue Shield of Michigan is seeking a detail-oriented customer service specialist to support workers’ compensation claims. You will handle claim inquiries from policyholders, agents, and providers via the ACD phone line and assist across Enterprise claims teams including subrogation.

This role also provides backup to intake and to the Service Center teams, processes documents in the claim system, and helps with workflow projects.

Qualifications

• High School Diploma or GED required; Associate degree preferred or equivalent experience.
• Minimum three years office experience with workers’ compensation knowledge; strong phone handling.
• Excellent verbal and written communication, and ability to manage multiple priorities.
• Ability to research information across systems and collaborate with teams.

Responsibilities

• Answers claim inquiries from policyholders, agents, injured workers, attorneys, pharmacies, and providers.
• Performs and coordinates IMEs/AMEs/DDEs/QMEs as needed for claims.
• Backs up Claims Document Analysts in reviewing and routing documents.
• Updates and routes documents in the claim system and data fields.
• Provides backup to intake for multi-state claims processing and issue resolution.
• Processes subpoenas and vendor referrals and participates in workflow improvement projects.
• Maintains knowledge of PPO/MPN/HCN provider information for customers.

Skills

Customer service

Telephone etiquette

Written communication

Organizational skills

Multitasking

Data entry

Research

Team collaboration

Education

High School Diploma or GED

Associate degree in insurance or related field

Tools

ACD telephone system

Document management system

Microsoft Word

Spreadsheet software

Job description

Blue Cross Blue Shield of Michigan is seeking a detail-oriented customer service specialist to support workers’ compensation claims. You will handle claim inquiries from policyholders, agents, and providers via the ACD phone line and assist across Enterprise claims teams including subrogation.

This role also provides backup to intake and to the Service Center teams, processes documents in the claim system, and helps with workflow projects.