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Customer Service Rep I - KLASC (Grand Rapids) C-S-R

UST HealthProof

Customer Service Rep

Full-time Shift: 8:00 am to 8:00 pm (Shift bidding process based on seniority) Grand Rapids, MI Assessment required - Customer Service Rep

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

  • 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.

Qualifications

  • 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.
Vacancy posted 6 hours ago
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