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BCN Correspondence Clerk (Detroit)

UST HealthProof

Job Description

Status Regular FT

Hours of Operation/Shift: M-F 7:30 am-5:30pm (shift bid and awarded by seniority)

Site - Detroit Whitmer

This position is accountable to analyze, evaluate, resolve and/or route unassigned, misdirected, customer interoffice and corporate correspondence to the appropriate corporate processing unit/department. Evaluates and mails appropriate forms, brochures and other requested document to subscribers based on their coverage. Performs investigation and research to resolve issues/problems impacting the processing of corporate correspondence.

  • Analyzes inbound and outbound correspondence to identify and determine benefits and designate which corporate inquiry processing department and/or specific correspondence should receive it and bring to closure.
  • Determines and distributes appropriate corporate forms and brochures, etc. according to subscriber contract benefit.
  • Validates weekly corporate Priority Alert listing to ensure timely processing of written inquiry.
  • Performs a tracking process which pulls samples of misdirected correspondence to determine which department they went to and if and when they were processed. Logs in a track report at the end of each month.
  • Appropriately designates previously misdirected, unassigned or undeliverable internal/external correspondence by reviewing and investigating the problem.
  • Contacts providers/facilities by mail, phone, email, or instant messaging for additional information to resolve where the correspondence should be directed.
  • Perform other related duties as assigned.

Qualifications

  • High school graduate or GED equivalent is required.
  • One (1) year customer service experience as a Document Support Clerk or similar position.
  • One (1) year of related work experience in areas such as claims processing or membership enrollment.
  • Demonstrated command of skills necessary for effective oral and written communication with providers and subscribers in a clear concise and professional manner.
  • Analytical skills to interpret, direct and code inquiry information.
  • Mathematical skills necessary to calculate and develop operational performance reports.
  • Detailed knowledge of BCBSM/BCN benefits/contract offering, policies, and procedures are necessary.
  • Knowledge of BCBSM/BCN servicing units, claim processing and corporate inquiry processing/reference files.
  • Knowledge of National Management Information Standard (NMIS).
  • Ability to lift and/or move up to 25 pounds.
  • Other related skills and/or abilities may be required to perform this job.

Job Info

  • Job Identification 14346
  • Job Category Operations
  • Legal Employer Blue Cross Blue Shield of Michigan Mutual Insurance Company
  • Locations Detroit, MI, United States
UST HealthProof
Vacancy posted 2 days ago
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