November 6, 2024

BlueCross BlueShield of South Carolina

Columbia

FULL TIME

Coordinator, Claims Customer Service

Summary

Functions as work leader for a claims customer service unit responsible for resolving customer inquiries and performing initial claims adjudication or non-medical appeals review. Assists with escalated and complex issues.

Description

Logistics:

This position is full time (40 hours/week) Monday-Friday in a typical office environment. Employees are required to have flexibility work any our 8-hour shift scheduled during hours of 8:00 AM – 6:00 PM. This role is located on-site at 4101 Percival Road, Columbia SC

What You’ll Do:

Distribute daily work to employees, tracks workload and employee performance, and makes appropriate decisions necessary to ensure all processing expectations and team goals are met.
Respond accurately and timely to inquiries from team members, including management, concerning customer inquiries, claims adjudication, appeals and other technical issues.
Investigates and initiates resolutions to complex problems.
Authorizes payment recovery, claim payments, or makes claim rejections based on documented information and provisions of state or federal law.
Identify issues with procedures and processes and provides feedback to management on changes and development.
Train new employees and introduces new material to all employees.
Develop, update, and maintain procedural manuals.
Serve 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’ll Need:

High School Diploma or equivalent
3 years of customer service experience and 1 year of claims or appeals processing experience OR bachelor’s degree in lieu of work experience.
Excellent verbal and written communication skills
Strong customer service skills
Proficient spelling, punctuation, grammar, and basic business math
Ability to handle confidential or sensitive information with discretion.
Knowledge of claims processing procedures
Microsoft Office

What We can Do for You:

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.

Subsidized health plans, dental and vision coverage
401K retirement savings plan with company match
Life Insurance
Paid Time Off (PTO)
On-site cafeterias and fitness centers in major locations
Wellness program and healthy lifestyle premium discount
Tuition assistance
Service recognition
Employee Assistance
Discounts to movies, theaters, zoos, theme parks and more

What to Expect Next:

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

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

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

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Equal Employment Opportunity Statement

Blue Cross Blue Shield 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 minorities, females, disabled individuals and 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 physical and mental disabilities.

If you need special assistance or an accommodation while seeking employment, please e-mail mycareer.help@bcbssc.com or call 1-800-288-2227, 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.