Accounting Technician II; Claims Processing-Medicare

Summary

Under general supervision, performs a variety of routine to moderately complex clerical/accounting functions such as inventory balancing, reconciliations, generating refund request letters, processing disbursements and deposits, keying journal entries and logging items in accordance with standard procedures in one or more of the following areas: general accounting, accounts payable, accounts receivable or related financial area. May complete special projects.

Why should you join the Blue Cross Blue Shield of South Carolina family of companies? Other companies come and go, but for more than seven decades we  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  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!

Position

Purpose:

• The Accounting Technician/Medicare Claims Overpayment Processor identifies, investigates, and recovers incorrectly paid medical claims by analyzing payment data, verifying over payments from sources like duplicate payments or system errors, documenting findings, and coordinating with providers for reimbursement or adjustments according to Medicare guidelines. Tasks include Medicare claim adjustments, Medicare Secondary Payer claim adjustments, preparing correspondence, creating, and updating accounts receivables and reviewing reports.
  
  This role requires strong analytical and communication skills, knowledge of medical terminology and claims processing, and the ability to maintain organized records and report on recovery efforts to ensure timely collection of over payments funds.

• CGS (), one of Blue Cross Blue Shield  South Carolina subsidiary companies.

• This is a full-time position (40-hours/week) working an 8hr shift Monday-Friday within the hours of 6:00am-6:00pm central time at 26 Century Blvd Suite ST610 Nashville TN 37214 in an office environment.

• Hybrid opportunities may be available after initial training period.

• SCA Benefit Requirements:
  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  Service Contract Act (SCA), employees are required to enroll in health insurance benefits regardless of other insurance coverage. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date.

• Prepares various financial data associated with refunds, invoices, recoupments, adjustments, cash disbursements, deposits, check voids and reissues, disputes, correspondence, or other data in support of the finance or accounting function. Ensures data is complete, accurate, and organized for processing. Provides supervisor with daily, weekly, and/or monthly summary reports of accounting activities for the position.

• Completes moderately difficult research using financial reporting systems, files, and other means to identify errors such as over payments or misapplication of funds. Resolves routine questions and problems, referring complex issues to higher levels.

• Performs calculations on financial documents to ensure accuracy of bank deposits, receipts, disbursements, refunds, or other accounting-related items.

• Provides other support duties related to the accounting/finance function that may include monitoring financial systems, keying journal entries, tracking funds, balancing accounts, maintaining inventory and receiving cash funds from customers, etc. May assist less experienced accounting clerks as needed.

• Determines, prepares, and distributes correspondence regarding monies due or erroneously received. Issues refunds as appropriate.

• Required
  
  Education:
  
  Associate  or equivalent in a job-related field.

• Degree Equivalency: 2 years job related work experience.

• Required Software and tools
  :
  Microsoft Office to include proficiency in Excel.

• Required
  
  Skills and Abilities:
  
  Good oral and written communication. Excellent organization skills and attention to detail. Strong business math skills. Typical office environment.

• MSP and claims experience is highly preferred.

• Accounting experience, particularly related to reconciliations, is preferred.

• Experience with HIGLAS (Healthcare Integrated General Ledger Accounting System) is preferred.

• Strong proficiency in Microsoft Excel is highly preferred.

• We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of…