• Job Description

  Req#: R1029809

  
  Summary
  

  Position Purpose:
  In the role as the Claims Customer Service Coordinator, one will be detail oriented and have the ability to function as a work leader for a claim’s customer service unit. One will also be responsible for resolving customer inquiries and performing initial claims adjudication or non-medical appeals review. The ideal candidate will also be able to assist with escalated and complex issues.

  
  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:

  • Distribute daily work to employees, track workload and employee performance, and make appropriate decisions necessary to ensure all processing expectations and team goals are met

  • Respond accurately and timely to inquiries from team members, including management, concerning customer inquiries, claims adjudication, appeals and other technical issues

  • Investigate and initiate resolutions to complex problems

  • Authorize payment recovery, claim payments, or makes claim rejections based on documented information and provisions of state or federal law

  • Identify issues with procedures and processes and provides feedback to management on changes and development

  • Train new employees and introduces new material to all employees

  • Develop, update, and maintain procedural manuals

  • Serve 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:

  • 3 years of customer service experience and 1 year of claims or appeals processing experience OR Bachelor’s Degree in lieu of work experience

  • High School Diploma or equivalent

  • 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

  We Prefer That You Have:

  • Leadership experience

  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.

• About the company

  When you hear "BlueCross BlueShield of South Carolina," you'll see people nodding in recognition. Most everyone knows who we are. As the only South Carolina-owned and operated health insurance carrier, we have been offering security to Palmetto State citizens for more than 70 years. We are also one of South Carolina's largest employers.

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