REQUIRED SKILLS:
* Bachelor's degree, preferably in Health Services Administration, Business Administration, Accounting, Finance or related field preferred
* Three (3) years in related field of claims processing, customer service, benefit policy interpretation or claims systems.
* Two (2) years BCBSM experience auditing or performing analytical assignments, benefit interpretation and customer service or working with the public preferred.
* Knowledge of NASCO/MOS claims processing, BCN/Facets, MEDCO, Medicare Advantage and BlueCard claims and knowledge of back-end data reporting preferred.
* Basic project management skills.
* Knowledge of generally accepted auditing principles and theories.
* General knowledge of Par Plan and/or Control Plan activities
* Excellent analytical, organizational, planning, verbal and written communication skills.
* Ability to analyze, investigate and organize ideas in recognizing, defining and formulating solutions to problems.
* Excellent interpersonal skills to effectively interface with all levels of BCBSM personnel, external auditors and customers.
* Proficient in current industry standard PC applications and systems (e.g. Word, Excel and Microsoft Office).
* Ability to work independently, within a team environment and handle multiple priorities.
* Other related skills and/or abilities may be required to perform this job.
