Address
Form of work
SalarySummary
Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation’s leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!Description
Job Purpose:
Responsible for maintaining database files to ensure timely/accurate claims processing. Updates various files/tables related to system access security, status codes and messages, and certain system editing. Develops solutions to business problems/requirements impacting the area's claims. Establishes system access/security for line of business. Troubleshoots/reviews production and test data with customers for system changes impacting customer-maintained tables/files.
Logistics:
This position is full-time (40 hours/week, 8 hours/day) Monday – Friday in a typical office environment and is onsite at 200 North Dozier Blvd., Florence, SC 29501. It is possible to work remotely once training is complete and performance standards are being met.
What You'll Do:
- Receives/evaluates/executes requests for table updates based on defined business requirements. Reviews/interprets mandates and contractor requirements to ensure that master/support files are accurately updated. Ensures claims are properly adjudicating according to requirements, requiring timely translation of benefit structures/procedures into a machine-readable language. Coordinates with various departments to resolve the source of related inconsistencies in system edits.
- Assigns internal and external security identification numbers, with appropriate levels of security for system access. Modifies and maintains secured files to ensure that system integrity is maintained and data security/confidentiality is not compromised.
- Maintains all work instructions for customer maintained tables and trains other coordinators on all processing systems in order to ensure continuity and consistency in file updates. Coordinates with Information Systems and Operations on the development, set up, and testing of new and existing customer maintained table.
- Prepares reports and records activities. Gathers required documentation and provides timely responses for internal and external audits. Also, investigates any security violations.
To Qualify for This Position, You'll Need:
- High School Diploma or equivalent.
- 2 years of claims processing or claims systems support experience.
- Strong analytical, interpersonal, communication (written/verbal), organizational, problem-solving and decision-making skills.
- The ability to work independently and under pressure with tight deadlines.
- Excellent customer service skills.
- The ability to demonstrate logical abstract thinking and assimilating/adhering to project goals and deadlines.
- Attention to detail.
- Working knowledge of relevant operating systems.
- Microsoft Office.
We Prefer You to Have:
- Benefit Files experience.
- Experience creating and modifying DB2 queries.
What Blue Can Do for You:
Our comprehensive benefits package includes:
- 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 a healthy lifestyle premium discount.
- Tuition assistance.
- Service recognition.
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 our 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.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.
Some states have required notifications. Here's
more information
.
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 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.
