Customer Service Rep I - MA Servicing (Detroit) C-S-R
UST HealthProof
Customer Service Rep
Full-time Department Hours of Operations: 8:00 am to 5:00 pm (Shift bidding process based on seniority) Detroit, 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 4 days ago
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