Offer summary

Qualifications:

High School Diploma or equivalent required; Associate Degree preferred., 4 years of experience in processing, researching, and adjudicating claims., Strong organizational, analytical, and problem-solving skills are essential., Proficient in Microsoft Office and possess strong verbal and written communication skills..

Key responsabilities:

Lead the team and serve as the subject-matter expert for claims processing.

Create reports, distribute workload, and train new employees.

Investigate and resolve complex claims issues while providing feedback to management.

Act as a liaison with other departments to address claims, system, and quality issues.

Job description

Summary

Functions as the team lead and subject-matter expert for a claims area. Responsible for creating reports, distributing workload and training new employees.

Description

Logistics

This position is full time (40 hours/week) Monday-Friday, work from home Richland County, SC or Lexington County, SC. Training will be 8:00 AM to 4:30 PM with flexible work hours after training.

What You Will Do:

Responds accurately and timely to inquiries from team members, including management, concerning claims processing and other technical issues. Investigates and initiates resolutions to complex claims problems.
Trains and assists new employees and unit personnel to ensure consistent application of established guidelines.
Identifies issues with procedures and processes and provides feedback to management on changes and development.
Serves as liaison with other departments to address claim, system and quality issues. May perform some testing functions and attend/participate in meetings as needed.

To Qualify for This Position, You Will Need:

High School Diploma or equivalent
4 years of experience processing, researching and adjudicating claims.
Strong organizational, analytical and problem solving skills.
Strong verbal and written communication skills.
Strong interpersonal and time-management skills.
Strong spelling, punctuation and grammar skills.
Basic business math proficiency.
Ability to handle confidential or sensitive information with discretion.
Microsoft Office.

We Prefer That You Have:

Associate Degree
Knowledge of mathematical or statistical concepts.
Ability to persuade, negotiate or influence.
Proficient in database software.

What We Can Do for You

401(k) retirement savings plan with company match.
Subsidized health plans and free vision coverage.
Life insurance.
Paid annual leave – the longer you work here, the more you earn.
Nine paid holidays.
On-site cafeterias and fitness centers in major locations.
Wellness programs and healthy lifestyle premium discount.
Tuition assistance.
Service recognition.
Incentive Plan.
Merit Plan.
Continuing education funds for additional certifications and certification renewal.

What to Expect Next

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and salary requirements.

Management will be conducting interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

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