Coordinator Claims Customer Service
Coordinator Claims Customer Service
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Salary Not Disclosed
1 Vacancy
Job Description
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: Planned Administrators Inc. (PAI) one of BlueCross BlueShields South Carolina subsidiary companies.
Location: This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift scheduled during our normal business hours of 8:30AM-5:00PM. This role is located at 17 Technology Circle Columbia SC 29203.
What Youll 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 Youll Need the Following:
Required Education: High School Diploma or equivalent
Required Work Experience: 3-years of customer service experience and 1-year of claims or appeals processing experience OR Bachelors Degree in lieu of work experience.
Required Software and Tools: Advanced knowledge of Microsoft Office.
Required Skills and Abilities:
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.
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)
On-site 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 pregnancy-related 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 call 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.
We participate in E-Verify 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:
IC
Employment Type
Full-Time
