Technical Information Specialist
Technical Information Specialist
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Job Description
Summary
Responsible for the maintenance of records and the processing of claims in medical review along with any and/or all of the following: processes ingoing/outgoing mail and prepares work for nursing staff. Troubleshoots claims prior to nurse review and after review. Monitors timeliness of claims processing and adjusts claims keyed incorrectly. Performs quality control of work processes.
Description
Logistics: Palmetto GBA one of BlueCross BlueShields South Carolina subsidiary companies.
Location: This position is fulltime 40hours/week) MondayFriday in a typical office environment. You will work an 8hour shift scheduled during our normal business hours of 6:00AM6:00PM. This role has offices in the following locations: Columbia SC; Florence SC; Augusta GA; Birmingham AL.
What Youll Do:
Processes denials of claims. Processes adjustment claims for both prepay and postpay departments.
Investigates and analyzes adjustment claim history and denial records.
Prescreens records for review and maintains accurate records of all claims.
Communicates with provider community and assists provider service department in responding to inquiries. Generates educational correspondence to providers regarding denials.
Performs quality control of work processes.
Assists manager with special projects.
To Qualify for This Position Youll Need the Following:
Required Education: Associates degree.
Degree Equivalency: 2years job related work experience.
Required Work Experience: 1 year administrative/clerical support.
Required Software and Tools: Working knowledge of Microsoft Office.
Required Skills and Abilities:
Working knowledge of word processing software.
Strong analytical organizational and customer service skills.
Strong verbal and written communication skills.
Proficiency in spelling punctuation and grammar skills.
Good judgment skills.
Ability to handle confidential or sensitive information with discretion.
Our Comprehensive Benefits Package Includes the Following:
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)
Onsite cafeterias and fitness centers in major locations
Education Assistance
Service Recognition
National discounts to movies theaters zoos theme parks and more
What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills advance their careers and contribute their unique abilities to the growth of our company.
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.
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 disabilitiesand 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 pregnancyrelated 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 or callext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a casebycase basis.
We participate in EVerify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Heres moreinformation.
Some states have required notifications. Heres more information.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
