- 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. Commercial, Medicare, Provider, etc.). Provide responses by telephone, email, chat, check-off letters, and/or automated letters.
- Follow department/corporate reporting requirements
- 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.
- High school graduate or GED equivalent.
- One (1) year of related work experience in areas such as public/customer service, sales representative, claims processing, membership enrollment. In the absence of BCBSM experience, (1) year of public contact in positions such as teaching, social service work, bank teller, medical or office assistant.
- Demonstrated knowledge of policies, practices and procedures related to membership.
- 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.
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Customer Service Rep I - Southfield, United States - Blue Cross Blue Shield of Michigan
Description
Job DescriptionCustomer Service Rep I
Full-time
Shift: 8:00 am to 5:30 pm
(Shift bidding process based on seniority)
Southfield, MI
Assessment required - Customer Service Rep
Analyzes, evaluates, resolves and primarily responds to low complexity level membership issues under various product lines.