Job Description
Receives, investigates, resolves and responds to telephone, walk-in and written inquiries from assigned accounts. Identifies and reports account concerns, attitudes and competitive activity to Account Representative and Sales Management. Develops and maintains customer confidence as it impacts decisions on retention and benefit changes. Documents prospective group information via the referral process for new business.
- Responds to routine telephone and written inquiries from account management, union representatives, agents and consultants. Reports and provides feedback to Management on group inquiries to ensure timely communication on key activities.
- Resolves account problems at the local BCBSM office, via telephone, or email inquiries.
- Monitors the research and resolution of complex inquiries and issues with, and in support of the sales representative, which impact group retention and sales.
- Prepares proposal rate requests, prepares new/existing group enrollment paperwork and benefit change paperwork. Secondary involvement in corporate work groups.
- Assists in and coordinates the open enrollment process. Actively participates in on-site open enrollment activities, account meetings.
- Effectively monitor and complete department/corporate reports to meet production and quality standards.
- Maintains and updates enrolled/prospective account records.
- Coordinates interdepartmental activities as required for new product/benefit implementation, customer service activities and contract administration to insure all corporate phases of the new product/benefit are implemented accurately (i.e., rates, BPIDs, etc.).
- Process urgent membership inquiries.
- Assist in notifying management in the troubleshooting of operational problems and difficulties, which occur in the performance of their duties.
- Develops and maintains a positive working relationship with other departments to facilitate the resolution at operational workflow issues.
- Develops and maintains a positive working Sales Support relationship with the Sales Staffs to identify and meet their business needs.
- Perform other related duties as assigned.
Qualifications
- High school graduate or GED equivalent is required.
- Three (3) years BCBSM/BCN Customer Service experience plus one (1) year public contact outside the corporation or four (4) years BCBSM/BCN Customer Service experience with verbal and written communication skills for customer interface.
- Must possess planning, organizational and human relations skills.
- Extensive knowledge of eligibility and underwriting rules, benefits, benefit delivery systems, billing, claims processing, resell process, rating and product compatibility.
- Extensive knowledge of BCBSM and subsidiary certificates, riders.
- Product compatibility and policies applicable benefits, exclusions, special classes, claims processing, underwriting, eligibility rules and group/ subscriber processing and special contracts.
- Knowledge of PCs and Microsoft Office.
- Must possess a marketplace awareness with knowledge of the decision making process relating to both union and management.
- Knowledge of functions/ responsibilities of corporate divisions and subsidiaries, Agent Sales policies and procedures.
- Extensive current knowledge of BCBSM and subsidiary systems is required for example (membership, billing, and customer rating systems).
- Other related skills and/or abilities may be required to perform this job.
All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.