Processor, Claims II (PART-TIME)
Company: BlueCross BlueShield of South Carolina
Location: Greenville
Posted on: January 24, 2023
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Job Description:
SummaryPosition Purpose:In the role as a Claims Processor II,
the ideal candidate will be able to resolve claims at a high volume
and be responsible for reviewing and adjudicating complex or
specialty claims. One will determine whether to return, deny, or
pay claims following organizational policies and procedures. The
ideal candidate will also be able to assist in training or
mentoring new staff members.DescriptionClaims Processor IIWhy
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 part-time (30 hours/week) position
Monday through Friday. Training hours will be 8:30am - 5:00pm
reporting onsite to 1000 Executive Center Drive, Greenville, SC
29616 for approximately 6 months. Upon completing training, and
meeting departmental standards, there will be an opportunity to
have a flexible work arrangement. What You'll Do:Examine and
process complex or specialty claims according to business/contract
regulations, internal standards and examining guidelinesEnter
claims into the claim system after verification of correct coding
of procedures and diagnosis codesVerify that claims have been keyed
correctlyEnsure that claims are processing according to established
quality and production standardsCorrect processing errors by
reprocessing, adjusting, and/or recouping claimsResearch and
resolve claims edits and deferralsPerform research on claim
problems by utilizing policies, procedures, reference materials,
forms, and coordinates with various internal support areasRespond
to routine correspondence and completes spreadsheet if applicableTo
Qualify for This Position, You'll Need:High School Diploma or
equivalent2 years of experience processing, researching, and
adjudicating claimsStrong organizational, analytical and judgment
skillsStrong oral and written communication skillsProficient in
spelling, punctuation, and grammarProficient in basic business
mathAbility to handle confidential or sensitive information with
discretionMicrosoft OfficeWe Prefer That You Have:5 years-of
experience processing and adjudicating claimsCES, CORDS, OR AMMS
experienceStrong time management skillsKnowledge of mathematical
and statistical conceptsProficient in word processing and
spreadsheet applicationsProficient database software skillsWhat 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 coverage401K retirement savings plan with company
matchLife InsurancePaid Time Off (PTO)On-site cafeterias and
fitness centers in major locationsWellness program and healthy
lifestyle premium discountTuition assistanceService
recognitionEmployee AssistanceDiscounts to movies, theaters, zoos,
theme parks and moreWhat 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 required proof of semester hours, please attach your
transcript to your application.Management will be conducting
interviews with the most qualified candidates, with prioritization
give 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
StatementBlueCross 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.
Keywords: BlueCross BlueShield of South Carolina, Greenville , Processor, Claims II (PART-TIME), Other , Greenville, South Carolina
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