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Position Purpose:
In the role as the Claims Customer Service Coordinator, the ideal candidate will function as a work leader for a claim's customer service unit, responsible for resolving customer inquiries, and performing initial claims adjudication or non-medical appeals review. The ideal candidate will also assist with escalated and complex issues. As a Claims Customer Service Coordinator, one will also the monitor the workload of claims customer service advocates.
Description
Claims Customer Service Coordinator
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!
Logistics:
This position is full-time position (40 hours per week) Monday through Friday 7:45am-4:15pm reporting onsite to 4101 Percival Road Columbia, SC 29219
What You'll Do:
• Distributes daily work to employees, tracks workload and employee performance, and makes appropriate decisions necessary to ensure all processing expectations and team goals are met.
• Responds 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.
• Identifies issues with procedures and processes and provides feedback to management on changes and development.
• Trains new employees and introduces new material to all employees. Develops, updates, and maintains procedural manuals.
• 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'll Need:
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.
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. If the qualifications require proof of semester hours, please attach your transcript to your application.
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.
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 abilities@bcbssc.com or call 1-800-288-2227, ext. 43172 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
Position Purpose:
In the role as the Claims Customer Service Coordinator, the ideal candidate will function as a work leader for a claim's customer service unit, responsible for resolving customer inquiries, and performing initial claims adjudication or non-medical appeals review. The ideal candidate will also assist with escalated and complex issues. As a Claims Customer Service Coordinator, one will also the monitor the workload of claims customer service advocates.
Description
Claims Customer Service Coordinator
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!
Logistics:
This position is full-time position (40 hours per week) Monday through Friday 7:45am-4:15pm reporting onsite to 4101 Percival Road Columbia, SC 29219
What You'll Do:
• Distributes daily work to employees, tracks workload and employee performance, and makes appropriate decisions necessary to ensure all processing expectations and team goals are met.
• Responds 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.
• Identifies issues with procedures and processes and provides feedback to management on changes and development.
• Trains new employees and introduces new material to all employees. Develops, updates, and maintains procedural manuals.
• 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'll Need:
- High School Diploma or equivalent
- 3 years of customer service experience
- 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. If the qualifications require proof of semester hours, please attach your transcript to your application.
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.
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 abilities@bcbssc.com or call 1-800-288-2227, ext. 43172 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
