Specialist, Technical Information
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Job Location:
Columbia, IN - USA
Monthly Salary:
Not Disclosed
Posted on:
9 hours ago
Vacancies:
1 Vacancy
Job Summary
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.
Working onsite at 17 Technology Circle Columbia SC 29203 or 200 North Dozier Boulevard Florence SC 29501
Processes denials of claims. Processes adjustment claims for both pre-pay and post-pay 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.
Required Work Experience:
Oneyear administrative/clerical support.
Required Education:
High School diploma.
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.
Required Software and Tools:
Microsoft Office.
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
Key Skills
- Information Management
- HIPAA
- FIPS
- Records Management
- Windows
- System Security
- NIST Standards
- IT Support
- DIACAP
- Medical Records
- FISMA
- RMF
About Company
You can’t reach new heights of performance unless you’re willing to invest in others. That people-first mantra has been our guiding light since we started in the Medicare business in 1965. Headquartered in Columbia, S.C., and with offices in Augusta, Ga.; Birmingham, Ala.; Camden, S.C ... View more
