Customer Service Rep I - KLASC (Grand Rapids) - C-S-R at Blue Cross Blue Shield of Michigan in Grand Rapids, Michigan

Job Description:

Customer Service Rep I
Full-time
Shift: 8:00 am to 6:00 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.

• 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.