Stop Loss Accounting Analyst
Stop Loss Accounting Analyst
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Salary Not Disclosed
1 Vacancy
Job Description
Summary
We are currently hiring for a Stop Loss Accounting Analyst to join BlueCross BlueShield of South Carolina. In this role as Stop Loss Accounting Analyst you will be responsible for submitting stop loss claim packets and responding to any requests for additional information. Additionally the claims must be tracked and monitored. Complex analysis is performed and queries are generated to file and validate the claim submissions.Here is your opportunity to join a dynamic team at a diverse company with secure community roots and an innovative future.
Description
Logistics
This position is fulltime 40 hours/week) MondayFriday 8:00am4:30pm in Columbia SC at our Percival Rd location.
What You Will Do:
- Prepare and file 50 and 100 stop loss claim packets. Run queries compile eligibility data and submit claim packet.
- Audit stop loss positions by running queries and comparing to the accumulated claims in the billing system. Research variances document discrepancies and make appropriate adjustments.
- Respond to audit letters. Work with other areas including claims marketing and managed care to obtain requested information.
- Track claims packet filing and MGU responses. Log all submissions audit letters receipts and responses in the tracking database/log.
- Provide manual monitoring of special stop loss scenarios including carved out pharmacy.
- Ensure the members stop loss positions are properly tracked and updated.
- Perform complex reviews of claims data in situations where the stop loss system does not accurately accumulate stop loss positions. Create custom reports and spreadsheets based on customer inquiries.
To Qualify for This Position You Will Need:
- Bachelors in a jobrelated field OR 4 years jobrelated work experience OR Associates and 2 years jobrelated work experience
- 3 years in accounting auditing billing claims membership or finance.
- Ability to compile information perform research and analyze data.
- Strong customer service and organizational skills.
- Excellent verbal and written communication skills.
- Ability to take initiative and meet deadlines.
- Attention to detail.
- Microsoft Office knowledge including Excel (understanding of formulas functions data analysis tools like PivotTables)
What We Prefer:
- Prior experience in billing banking finance queries excel macros membership or accounting work experience.
- Experience with AMMS claims processing system membershipand PFAB claims billing systems.
- Strong knowledge and use of the Group Library Cloud.
- Intermediate working knowledge in Microsoft Office suite.
- Able to work in a fastpaced working environment with strict deadlines for specific assigned tasks.
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.
- Onsite 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.
We participate in EVerify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.
Some states have required notifications. Heresmore 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 email or callext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a casebycase basis.
Required Experience:
IC
Employment Type
Full-Time
