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Blue Cross Blue Shield of Michigan

Nonprofit mutual insurer administering health benefits

Customer Service Representative 1

Customer SupportConfirmed live in the last 24 hours
Full-timeGrand Rapids, MI, USANo salary listedIn-person

About the Job

Requirements

  • High school graduation or GED equivalent is required.
  • One year of related work experience in public or customer service, sales, claims processing, or membership enrollment is required; qualifying public-contact roles include teaching, social service work, bank teller, medical assistant, or office assistant.
  • Demonstrated knowledge of policies, practices, and procedures related to membership is required.
  • Ability to analyze data and resolve problems related to membership is required.
  • Command of the skills necessary for clear, concise, and tactful oral and written communication is required.

Responsibilities

  • Analyze, evaluate, resolve, and primarily respond to low-complexity membership issues across various product lines.
  • Conduct low-complexity internal and external research to determine and request data needed to handle membership inquiries.
  • Analyze and service product lines in the area, including Facility and Professional, and respond by telephone, check-off letters, and/or automated letters.
  • Follow department and corporate reporting requirements, including PCRS, ICS, Special Surveys, and manual counts.
  • Organize work to meet National, Corporate, and Department production and quality standards.
  • Reroute misdirected inquiries.
  • Evaluate membership issues and inquiries and price or adjudicate low-complexity claims and inquiries.
  • Interact with people inside and outside the organization to resolve inquiry- and claim-related problems.
  • Influence customers to accept the reasonableness of decisions and actions.

About the Company

Blue Cross Blue Shield of Michigan

Nonprofit mutual insurer administering health benefits

Nonprofit mutual insurer Blue Cross Blue Shield of Michigan administers health benefits for more than 4.3 million members in Michigan and across the United States. It offers group health plans for businesses of various sizes, including a private exchange that lets employers provide a selection of market-leading benefits, plus life and disability insurance. It operates through employer-sponsored plans and a network-based coverage model, with tailored plans and benefits administration. Its goal is to keep health care costs affordable and predictable for individuals and employers while providing broad access to coverage nationwide as an independent licensee of the Blue Cross Blue Shield Association.

Company size
10,001+
Company stage
Not listed
Total funding
Not listed
Headquarters
Detroit, MI
Founded
1938

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