Technician, Accounting III

Summary Description Why should you join the Blue Cross Blue Shield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, 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, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!

A Medicare Claims Overpayment Claims 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.

Location:

This is a full-time position (40-hours/week) working an 8hr shift Monday-Friday within the hours of 6:00am-5:30pm central time at 26 Century Blvd Suite ST610 Nashville TN 37214 in an office environment. Internal employees who are currently working remote may continue to work remotely. Internal employees working in office can potentially work a hybrid schedule (3 days in office, 2 days work from home).

Blue Cross Blue Shield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). To comply with the McNamara-O'Hara Service Contract Act (SCA), employees must enroll in our health insurance even if they have other health insurance. Employees will receive supplemental pay for health insurance until they are enrolled in our health insurance, first of the month following 28 days after the hire date.

• Prepares various in-depth 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 to complex research using financial reporting systems, files, and other means to identify errors such as over payments or misapplication of funds.
• Resolves most questions and problems, referring most 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, tracking funds, balancing accounts, maintaining inventory and receiving cash funds from customers, etc.
• Assists less experienced accounting clerks as needed.
• Prepares journal entries and account reconciliations.
• Responds to telephone and written inquiries from internal and external customers to ensure accurate billing, payments and/or collections.

• Bachelor's degree in Accounting/Finance.
• or Associate's degree in Accounting/Finance plus 2 years of experience supporting accounting or financial operations OR 4 years of experience supporting accounting or financial operations.
• Good oral and written communication and customer service skills.
• Excellent organization skills and attention to detail.
• Strong business math skills.
• M…