Customer Service Rep I - MA Servicing (Detroit) C-S-R

Blue Cross Blue Shield of Michigan; Detroit (MI); On-site; USD 42,000 - 55,000; Full time

Job summary

Blue Cross Blue Shield of Michigan is seeking a Non-Manager Member Services Associate to analyze, evaluate, and resolve low complexity membership issues across multiple product lines. You will respond to inquiries by phone, mail, or automated systems and provide accurate data requests.

Responsibilities include organizing work to meet production standards, rerouting misdirected inquiries, and collaborating with internal teams to resolve problems.

Qualifications

• Demonstrated ability to analyze data and resolve problems related to membership.
• Clear, concise oral and written communication skills.
• Experience in customer service, claims processing, or related membership support is preferred.

Responsibilities

• Analyze and respond to low complexity membership inquiries across product lines.
• Provide data-driven explanations and responses via phone, letters, or automated communications.
• Follow department reporting requirements and meet production and quality standards.
• Organize work effectively to handle inquiries and reroute misdirected requests.
• Collaborate with internal teams to resolve membership-related issues and price adjudication when needed.
• Influence customers toward reasonable decisions and maintain customer trust.

Skills

Data analysis

Communication

Problem solving

Education

High school diploma or GED

Job description

Company: Blue Cross Blue Shield of Michigan

Industry: Health Insurance and Health Care

Level: Non-Manager

JobFamily: Multi-divisional

Compensation: Competitive Total Compensation Package

About Us

When you think of Blue Cross Blue Shield of Michigan for health insurance, you can know you’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.

• Plans for employers and individuals that meet today’s needs, budgets and lifestyle
• The largest network of doctors and hospitals in the state
• Lower health care costs
• Higher quality health care
• Grants and programs that promote better health throughout Michigan

Mission: We commit to being our members’ trusted partner by providing affordable, innovative products that improve their care and health.

Overview

Position Summary: Analyzes, evaluates, resolves and primarily responds to low complexity level membership issues under various product lines.

Responsibilities

• Primarily conducts low complexity internal and external research to determine and request the data needed to handle inquiries regarding membership.
• Analyze and service various product lines in the area (i.e., Facility, Professional). Provide responses by telephone, check-off letters, and/or automated letters.
• Follow department/corporate reporting requirements (i.e., PCRS, IC…)
• Organize work to meet National/Corporate/Department Production and Quality Standards.
• Reroute misdirected inquiries.
• Primarily evaluates membership issues/inquiries and price/adjudicates low complexity claims/inquiries.
• Interact with others inside and outside the organization to resolve the inquiry/claim related problems.
• Influence customers to accept the reasonableness of decisions and actions.

Requirements

• Education: High school graduate or GED equivalent.
• Experience: 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.
• Knowledge: Demonstrated knowledge of policies, practices and procedures related to membership.
• Skills: Demonstrated ability to analyze data and resolve problems related to membership; demonstrated command of all skills necessary for oral and written communications in a clear, concise and tactful manner.

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.

All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.