Claims Technician

Summary

We are currently hiring for a Claims Customer Service Manager to join Blue Cross Blue Shield of South Carolina. You will be performing routine but varied clerical duties in accordance with standard procedures. This includes clerical duties such as photocopying, compiling records, filing, tabulating, posting information, distributing mail, screening, scanning, data element verification and document indexing. Applies knowledge of department policies and procedures and utilizes a general understanding of other departments' functions.

Maintains records, prepares forms, verifies information and resolves routine problems. Ensures claims are processed in a timely manner.

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!

PGBA - one of Blue Cross Blue Shield's South Carolina subsidiary companies

This position is full-time (40-hours/week) Monday-Friday from 8:00am-5:00pm in a typical office environment. This role is located on-site at 200 North Dozier Boulevard, Florence, SC 29501.

• This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen.

Blue Cross Blue Shield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). Under the McNamara-O'Hara Service Contract Act (SCA), employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date.

• Receives, opens, sorts and distributes incoming departmental mail or work requests. Checks workflow documents to ensure required information is available. Requests any missing documentation as needed. Scans all documents for storage in the electronic repository. Prepares correspondence or packages for internal/external mailing.
• Screens and verifies information. Ensures proper and accurate processing flow of all paper claims and correspondence in accordance with department standards for quality and production, contract regulations, policies and guidelines.
• Conducts data element verification of data elements for those that fail the mapping process prior to claims adjudication. Applies appropriate indexes as needed to claims and/or correspondence.
• Maintains departmental logs, spreadsheets or databases. Effectively uses all available reference materials in performance of daily functions.
• Keeps track of supply inventory and/or orders supplies as needed.

• Required
  
  Education:
  
  High School Diploma or equivalent
• Required
  
  Skills and Abilities:
  • Strong organizational and analytical skills.
  • Good communication and organizational skills.
  • Detail-oriented.
  • Ability to handle confidential or sensitive information with discretion.
• Preferred
  
  Skills and Abilities:
  • Ability to accurately key 5000 ksph or 30 wpm.
  • Knowledgeable in word processing and spreadsheet applications.

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits for 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

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.

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.

Blue Cross Blue Shield 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…