SUMMARY Perform production and quality audits to ensure operations are effective, consistent and in compliance with business rules and processes.  Primary focus includes, but is not limited to auditing the Document Specialists, Claims Document Analysts, Senior Document Analysts, Mail Clerks, and Inserter Operators. Responsible for performing administrative and support tasks which may be highly confidential and sensitive in nature.   PRIMARY RESPONSIBILITIES    Completes production and quality audits, reviewing completed work in comparison to established documented procedures to determine accuracy while providing support to staff as an acting SME. Orients new employees to the departmental and unit procedures. Collaborate with management and stakeholders to ensure understanding, alignment, and consistency in workflow performance. Partner with training, management, and stakeholders to identify training needs based on quality assessment results Compiles, creates, prepares,...

SUMMARY: Primarily responsible for assisting Large Account Underwriters and Business Development Consultants in growing and maintaining a profitable book of business and assisting agents with inquiries related to underwriting rules, procedures and regulations. Reviews policy structures to determine if changes need to be made to stay in compliance with bureau rules and regulations. Provides customer service to agencies and policyholders related to complex inquiries, policy and audit information. Contacts include state rating bureaus, Large Account Underwriters, Business Development Consultants, Business Development Directors, Service Center Managers, Underwriting Technical Advisor, Service Center staff, Finance Department, Claims Department, agents and policyholders. PRIMARY RESPONSIBILITIES: This description identifies the responsibilities typically associated with the performance of the job. The percentage of time in any responsibility may vary between positions. Other...

SUMMARY: (Brief 3-5 sentence paragraph outlining the main purpose of the job) Responsible for providing administrative support, some of which may be highly confidential and necessitate independent judgment, for assistant general counsel in the Legal Department of the Office of the General Counsel. Contacts are mainly with attorneys, tribunals, medical office personnel, policyholders, claims supervisors and claims examiners as well as other clerical or administrative employees.   PRIMARY RESPONSIBILITIES: (Brief bullet points detailing the major duties, not tasks, for this job and the % of time spent on each. Please list them in the order of importance).   · Receive and screen incoming calls and visitors and provide information or route to the appropriate person. · Inform appropriate staff of issues as necessary. · Maintain up to date expertise and broad knowledge in all facets of workers’ compensation litigation. · Update databases and prepares reports utilizing standard...

SUMMARY:  Primarily responsible for supporting the document management including media by analyzing, processing, indexing, re-indexing and assigning a document type and/or sub-doc type to all documents received by all departments within the Enterprise. Documents are received via OnBase and/or paper, fax, media and email. The incumbent must distinguish what department a document belongs to, apply proper criteria to electronically route the document into an electronic database, and initiate workflow of these documents to appropriate core business units in an accurate and timely manner. Primary contacts include other departmental personnel, as well as external vendor contacts. This role is also responsible for processing of incoming documents for the Subrogation, Legal, Commercial Auto, Fronting Agreements, Assigned Risk, Regulatory, Investigations and Medicare/Medicaid teams. Subject matter expert for Document Specialists and Claims Document Analysts.   PRIMARY RESPONSIBILITIES:...

SUMMARY:  This role will focus on maintenance of our incoming workload, issue resolution and first report of injury (FROI) issues.  This position determines jurisdiction for entry of first notice of injury (FNOI) from multiple sources and distributes to the proper destination.  Enters and supports priority and special requests, including correcting newly-created claims.   ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. •    Identifies jurisdiction, date of injury and special/additional handling items; researches and re-indexes non-new claim submissions to route to appropriate handling.  •    Receives incoming general new claims calls for all entities; backup for ACD calls in the event of telephone system shutdown. •    Makes changes, corrections and updates on newly created and/or existing claims or submissions as well as guiding end-users on process techniques in various applications. •    May serve as a resource regarding intake-related...

SUMMARY:     Primarily responsible for receiving and inventory areas, coordinating, storing, stocking, and distributing a wide variety of mail, materials and supplies throughout the building, including mail room, print center, IT, etc.  Unloads shipments from receiving dock and sorts items for delivery.  Responsible for the maintenance of archival file storage and prepares files for storage or destruction off site. Contacts include buyers, delivery personnel, and employees throughout the company. When the incumbent qualifies and is able to perform all responsibilities independently, they will progress to a level II.     ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.   Maintains company stock & inventory and assists with purchase requests.   Fulfills, ships, and delivers stock materials and special orders to departments.   Maintains a supply of marketing materials and...

SUMMARY Medical Bill Review Specialist I Primarily responsible for analyzing bills for multi-state Workers Compensation medical claims to determine appropriateness of services billed. Responsible for analyzing simple billings by utilizing our Medical Bill Review (MBR) software to determine appropriateness of codes. Responsible for making bill review processing determinations according to rules, regulations, and/or third-party partners. Medical Bill Review Specialist II Primarily responsible for performing technical review of more complex medical bills, including modifiers, anesthesia, & psychiatric. Responsible for analyzing billings including outpatient hospital and multiple surgeries by utilizing our Medical Bill Review (MBR) software to determine appropriateness of codes and excessive charges. Also responsible for analyzing assigned medical bills to determine compliance with business rules, client specific requirements and multiple state rules, regulations and...

SUMMARY:   Delivers and facilitates training to groups, managers, external customers and/or on-the-job (one-on-one) training as well as collaborates with content team to design training material. This position is primarily responsible for the training needs of union represented jobs with a smaller amount of time spent on various non-union jobs as a secondary responsibility. Topics primarily relate to operational training, processes, procedures and technologies.  Provides guidance in the design and development of training programs and preparation of training materials. Evaluates training, develops recommendations, and project manages training solutions. Works with managers to identify methods of improving employee performance. PRIMARY RESPONSIBILITIES: Conducts training needs analysis, design, and development training.  Partners with leaders, Business Analysts, Subject-matter experts, content development and other trainers to implement training plans  Manages implementation...

SUMMARY:  Perform production and quality audits to ensure operations are effective, consistent and in compliance with business rules and processes.  Primary focus includes, but is not limited to, auditing the Service Center teams Claims Support, Business Development, Billing Service Center.   Responsible for performing administrative and support tasks which may be highly confidential and sensitive in nature. PRIMARY RESPONSIBILITIES:  ·    Conducts and executes the production statistics and quality audits of completed work in comparison to established documented procedures to determine accuracy within the Service Center in a timely fashion while being in compliance with statutory regulations (30%). ·    Partner with management, union representatives, human resources, and team members to establish and maintain production and quality standards for Service Center teams (15%).  ·    Compile, create, prepare and review information, audits and reports for accuracy as requested or...

SUMMARY: Customer Service Assistant is focused on providing excellent customer service for Retail Truck Insurance Agency. Duties include assisting clients via phone calls and emails, administrative and data entry tasks to support the service of current clients and potential clients.  This is a hybrid position reporting to our AF Group -La Palma Campus*.      RESPONSIBILITIES/TASKS: Take client phone calls and communicate policy change requests to Team Members.   Issuing Certificates of insurance for our clients.  Inputting potential business in our core C1 system as well as various online platforms.  Creating of policy files in Image Right System.  Daily / weekly filing of correspondence to Image Right System. Process client payments in C1 system, assisting with payments made to Liberty Premium finance via the PBS billing system Manage policy receipt policy, reviews policies for accuracy and emailed or mailed to retail Customers. Works effectively on the assigned...

Departmental Summary This role is focused on leading sales and account management activities across West Michigan with primary accountability for retention, customer relationships, and long-term account performance for 50+ sized group customers include Key and Large group business. Preferred Qualifications / Experience: Experience leading and managing a regional portfolio of Key and Large group customers (50+), with strong familiarity of the West Michigan market dynamics. Established relationships and/or demonstrated ability to effectively engage with regional stakeholders, including employer groups, brokers/consultants, agents, chambers, and community organizations. Proven ability to navigate complex, multi-stakeholder environments, including groups with employer executives, and multiple decision-makers. Demonstrated success leading large, complex renewal strategies, including positioning, negotiation, and issue resolution across a diverse book of business....

Responsible for designing, developing, configuring, testing, and documenting applications, integrations, tools, systems, and components based on project or change request specifications and procedures using knowledge of and ability to code in JavaScript (including user interfaces), Java, .Net, and other web-related technologies as well as or other object-oriented development languages. Responsible for the production support of internally developed and third-party applications, processes, and reports. Acts as an application owner for incident management, technical troubleshooting, root cause analysis, correction of software defects, and production application validation.  Assist in design and maintenance of existing software.  Follows standard troubleshooting and development procedures using various tools. May assist with complex incident management situations.  Works within the System Development Life Cycle. Top level expert in one or more highly specialized areas of...

Non-Exempt/Bargaining Unit Posting Date Posted: 05/14/2026 Date Closed: 05/22/2026 Local/Seniority Unit – 1781/3207 Department – 126460 Grp Cust Membership & Billing Salary Grade – B Number of openings – One Shift – Mon-Fri Flex start between 7-8:30am ending 3:30-5pm Site/Location: Jefferson Building Status – Regular Full Time   Performs a variety of clerical duties related to inventory, and department systems/applications that require familiarization of standardized work routines, involving incoming, outgoing, inter-office and misdirected departmental mail.  Responsible for tracking and routing incoming work according to departmental procedures (i.e., electronic, paper, etc.). Enters and monitors data for accuracy and completeness into the department systems and applications.  Handles routine inquiries via phone or correspondence. Checks and verifies information, or processes documents that require minimal claim, benefit,...

The Director, Ancillary and TPA Solutions is accountable for the strategic development and oversight of ancillary solutions for Commercial Markets and Government Programs, where applicable.  This role is also accountable for the ongoing oversight of all Shared Administration capabilities, operational effectiveness and compliance and development and implementation of new TPA related solutions.  This role is accountable for assessing the market solutions for ancillary, complementary and TPA solutions and negotiating favorable contracts on behalf of BCBSM and holding engaged vendors accountable for achieving contract requirements.   Oversee contract and vendor management activities for ancillary and complementary solution vendors, including assessment of market options, negotiation of contract terms, establishment of performance expectations, and enforcement of contractual requirements across Commercial Markets and applicable Government Programs. Provide enterprise oversight of...

SUMMARY:     Leads the design, development, and support of modern software solutions in an Agile/Scrum and DevOps environment, with specialization in Enterprise Content Management (ECM) and workflow automation. Applies modern engineering practices CI/CD, automated testing, infrastructure as code, and observability to deliver secure, resilient, and scalable services. Provides technical leadership for ECM technologies (e.g., OnBase, Kofax, ImageRight or similar) and integrates content services with enterprise applications and cloud platforms.   RESPONSIBILITIES/TASKS:  Serves as technical lead for Enterprise Content Management (ECM) platforms and content services (e.g., OnBase, Kofax, ImageRight), including workflow automation, integrations, and platform modernization. Leads end to end delivery for ECM and content enabled applicationsplanning, design, build, test, release, and support and ensures alignment to enterprise architecture standards. Partners with Product...

We are seeking two Digital Product Owners to support Digital Experience in distinct capacities. Additional details regarding each role are provided below. Retail Site : We are looking for a product owner to join our Digital Experience team, supporting the retail website and pre-authenticated member journey.  In this role, you will own and prioritize a defined product roadmap, partnering closely with engineering, design and business stakeholders to deliver seamless digital experiences for prospective members – from plan discovery and comparison through enrollment.   Member Portal: We are looking for a a product owner to join our Digital Experience team, supporting the authenticated member account experience.  In this role – you will own and prioritize a defined product roadmap, partnering closely with engineering, design and business stakeholders to deliver intuitive, reliable digital tools that help members manage their health benefits with confidence....

SUMMARY:       The primary focus of this role is to support Star Ratings projection modeling and analytics for Medicare Advantage. The Data Analyst will work with large datasets to generate insights, perform ad-hoc analyses, and assist in monitoring key performance indicators related to CMS Star Ratings.    RESPONSIBILITIES/TASKS:   Supports Stars projections through data analysis, modeling scenarios & ensuring accurate Star Ratings forecasts Monitors CMS regulations & incorporates policy updates, ensuring accurate Stars projection model maintenance. Utilizes software tools and programming to query & manipulate Star metrics data for accurate reporting & analytics. Develops and improves workflows and business processes within area(s) to improve customer service, decrease operational costs, and improve overall quality.  Identifies and/or analyzes business problems and devise procedures for solutions to the problems.  Effectively leads projects in...

SUMMARY   Responsible for leading the enterprise Agent Enablement arm, providing strategic direction, governance, and oversight across all agent related functions, including Agent Experience, Agent Administration, Agent Engagement, Agent Communications, and Sales Learning. This role ensures agent enablement strategies are integrated, aligned to Segment Sales priorities, and designed to support agent effectiveness and consistency. ESSENTIAL DUTIES AND RESPONSIBILITIES  include the following.  Other duties may be assigned. Provide enterprise leadership and oversight for the Agent Enablement function, ensuring cohesive strategy, governance, and prioritization across Agent Experience, Agent Administration, Agent Engagement, Agent Communications, Channel Partnerships and Sales Learning.  Establish operating standards and lead change initiatives to evolve agent enablement models. Partner with Segment Sales leadership to align agent enablement strategies to sales...

We are looking for a Product Manager to lead the mobile app product strategy and experience for both iOS and Android platforms.  In this role, you will define and drive the mobile roadmap, translating organizational goals and member needs into a cohesive, prioritized product vision that delivers measurable outcomes. Define and evolve the digital product vision for unauthenticated .com experiences, including marketing pages, acquisition flows, and onboarding journeys, informed by customer research, competitive analysis, and market trends. Own and maintain a prioritized product roadmap aligned to business OKRs; communicate progress, tradeoffs, and outcomes to leadership and governance stakeholders. Drive conversion rate optimization strategy across the funnel identifying friction points, defining hypotheses, and partnering with analytics and UX teams to improve acquisition and onboarding metrics. Establish feature definitions, acceptance criteria, and success metrics...

  Departmental Summary Support implementation, monitoring and enforcement of Commercial Business Strategy, using GrpCRM for the identification, tracking, escalation and resolution of different ASC-focused objects, support requests and workflows, including: Monitoring and resolution of GrpCRM DFund / UCCR requests Buy-Up request fulfillment, governance and execution ASC contract signature handling (fulfillment, execution, and closure) Activation of highly-controlled ASC impacts such as mandated chgs Monitoring and accuracy of 'ASC Account 360' data Oversee adherence of legal, financial, product and audit controls for ASC grp arrangements and purchases Extensive experience with GrpCRM – as a user, a task manager, workflow administrator, and report builder Support GrpCRM UAT testing, as applicable Support impact assessments including identification and tracking of group-specific impacts Document and measure ongoing quality processes owned and/or managed by the ASC...