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.