Full-Time
Customer Service Representative 1
Blue Cross Blue Shield of Michigan
10,001+ employees
Nonprofit mutual insurer administering health benefits
No salary listed
Detroit, MI, USA
In Person
 Customer Experience & Support (1) |
|---|
- 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; or one (1) year of public contact in positions such as teaching, social service work, bank teller, medical assistant/office assistant.
- One (1) year of total related experience or in the absence of internal BCBSM experience, the following may apply: One (1) year of related work experience in areas such as public/customer service, sales representative or claims processing.
- 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.
- 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, ICS, Special Surveys and Manual counts).
- 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.
Blue Cross Blue Shield of Michigan is a nonprofit mutual insurer that administers health benefits for more than 4.3 million members in Michigan and nationwide. It offers group health plans for businesses of various sizes, including a private exchange that lets employers provide a selection of benefits, along with life and disability insurance. Benefits are delivered through employer-sponsored plans and a network-based coverage model, with plans tailored to organizations and employees. The goal is to keep health costs affordable and predictable while providing broad access to coverage and employee benefit options.
Company Size
10,001+
Company Stage
N/A
Total Funding
N/A
Headquarters
Detroit, Michigan
Founded
1938
Simplify's Take
What believers are saying
- Michigan Medicine disruption opens a 2026 opportunity to win employer switches.
- The Grand Rapids consolidation improves occupancy and supports BCBSM's transformation narrative.
- Life and disability products expand cross-sell potential with employer health-plan renewals.
What critics are saying
- Michigan Medicine could leave BCBSM networks on July 1, 2026, triggering churn.
- The antitrust lawsuit over self-funded plan stop-loss fees threatens damages and injunctions.
- Carrier-switching employers can rapidly move to HAP, Priority Health, or UnitedHealthcare.
What makes Blue Cross Blue Shield of Michigan unique
- BCBSM is Michigan's largest nonprofit mutual insurer, serving 4.7 million members.
- Value Partnerships began in 2002 and spans over twenty collaborative quality initiatives.
- Blueprint for Affordability ties provider payments to total cost and outcomes, not volume.
Help us improve and share your feedback! Did you find this helpful?
Your Connections
People at Blue Cross Blue Shield of Michigan who can refer or advise you
Benefits
Remote Work Options
Company News
Employer sues Blue Cross Blue Shield of Michigan for alleged ERISA violations.
The Southwest Michigan Regional Chamber's 2025 Business Recognition Breakfast Award Ceremony & Annual Meeting, presented by Blue Cross Blue Shield of Michigan, Corewell Health, and Honor Credit Union is Friday, February 21st!
A new lawsuit claims that Blue Cross Blue Shield of Michigan violates federal and state antitrust laws by charging an administrative fee when clients who self-fund their employee health benefits opt to use another carrier for stop-loss coverage.
Blue Cross Blue Shield of Michigan introduced its COVID vaccine policy in October 2021, which mandated all employees be fully vaccinated or obtain a religious or medical accomodation.
A federal jury in Detroit awarded more than $12 million Friday to a former Blue Cross Blue Shield of Michigan (BCBSM) employee who was terminated after declining to get a COVID-19 vaccination, citing religious discrimination.