Mem Maintenance Technician
Blue Cross Blue Shield of Michigan

Detroit, Michigan

Posted in Insurance


This job has expired.

Job Info


Non-Exempt/Bargaining Unit Posting

Date Posted: 05/17/2024

Date Closed: 05/24/2024

Local/Seniority Unit - 1781

Department - 126540 BCN-Group Membership and Billing

Salary Grade - B

Number of openings - One (1)

Shift - Mon-Fri Flex Start 7a -9a

Site/Location: Jefferson Building

Status - Regular Full Time

Update and maintain accuracy of the membership database. This includes, but is not limited to, processing electronic work queues, SF•s, membership applications, PCP selection processing, membership changes submitted from employer groups via printed reports and any membership data base auditing and reports. Proactively manage PCP selection and membership errors for all groups. Responsible for interacting directly with employer group representatives, BCBSM Sales and Marketing staff, agents and Third Party Administrator•s (TPA) to identify and resolve inquiry-servicing issues.

  • Process electronic write-off queues, SF•s, paper applications, PCP selections, group submitted reports, and system produced reports. Contact employer group when necessary to obtain needed information to process membership/PCP changes. Document contact through BCN•s customer tracking/imaging/workflow system. Receive and respond to inquiry-servicing issues from employer group representatives, BCBSM Sales and Marketing staff, agents and TPA•s.
  • Process errors resulting from automated processes (Generic membership loads, write-offs, pre-billing error reports, pre-capitation error reports, automated PCP selection process, etc.)
  • Periodically conduct system membership audits (i.e. employer group specific audits).
  • Maintain consistent rapport with Group Account Analyst and Sr Group Account Analyst when questions/concerns arise regarding documentation received from employer groups.
  • Maintain Inventory Tracking database. Maintain Workforce Management Tools system for production control including the input of data and working of regular reports.
  • Other duties as assigned by leadership of Membership and Billing. Participate in corporate committees and work groups.

"Qualifications"
  • High School diploma or GED required.
  • Associate Degree or two (2) years of full time college credits preferred.
  • Two (2) years of prior work experience in general office processes or customer service required.
  • One (1) year experience in a managed care setting preferred.
  • Basic knowledge of membership underwriting guidelines preferred.
  • Basic knowledge of HMO•s and capitation procedures preferred.
  • Knowledge PC software applications used for word processing and spreadsheets preferred.
  • Knowledge of BCN/BCBSM membership and billing systems preferred.
  • Knowledge of MACESS imaging system preferred.
  • Excellent verbal and written communication skills required.
  • Strong analytical and mathematical skills required.
  • Intermediate knowledge of Microsoft Word and Excel preferred.
  • Excellent organizational skills with the ability to work independently while handling multiple projects and timelines required.
  • Data entry requirement of 90 NKPM with 99% accuracy required.
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.


This job has expired.

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