Summary
Provides direction and guidance to appeals, customer service, and claims processing staff for multiple operational areas.
We strongly prefer experience in FISS, MAS, PECOS, and HIGLAS and management in a Medicare Administrative Contractor operational setting.
Description
Location: This position is onsite full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-5:00PM. It may be necessary, given the business need to work occasional overtime. You may be required to travel between buildings. This role is located at 17 Technology Circle Columbia, SC 29203
What You Will Do:
Directs customer service, claims processing, and/or appeals staff in ensuring prompt and accurate processing of items and inquiries. Develops and supports strategic initiatives to enhance provider and customer satisfaction.
20% Works closely with areas to track performance and develop measures of success. Implements process improvements.
10% Identifies system limitations and serves as project leader on system enhancements and updates.
10% Leads and supports achievement of departmental, divisional, and corporate strategic objectives. Collaborates with other functional areas to resolve multi-functional issues. Provides necessary assistance and resources when necessary.
10% Develops and monitors budget and resources for all assigned areas. Responsible for the selection, training, and development of staff. Ensures excellent customer service is given to employees, customers, management, etc.
To Qualify for This Position, You'll Need the Following:
Required Education: Bachelor's
Degree Equivalency: 4 years job related work experience or Associate's and 2 years job related work experience (Equivalency not applicable for the Celerian Group. Bachelor's degree required.)
Required Work Experience: 7 years of healthcare program or customer service experience to include budget management experience including 3 years of management/supervisory experience OR 3 years of equivalent military experience in grade E4 or above (may be concurrent).
Required Skills and Abilities: Strong organizational, analytical, presentation, and customer service skills. Strong oral and written communication skills. Ability to persuade, negotiate or influence. Ability to handle confidential or sensitive information with discretion. Proficient spelling, punctuation, grammar, and basic business math.
Required Software and Tools: Microsoft Office.
We Prefer You to Have:
Experience in FISS, MAS, PECOS, and HIGLAS
Management in a Medicare Administrative Contractor operational setting
Our Comprehensive Benefits Package Includes the Following:
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
Education Assistance
Service Recognition
National discounts to movies, theaters, zoos, theme parks and more
What We Can Do for You:
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.
What To Expect Next:
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.
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 individuals with disabilities and protected 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 disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.
If you need special assistance or an accommodation while seeking employment, please email [email protected] or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information.
Some states have required notifications. Here's more information.
Skills Required
- Bachelor's degree
- 7 years healthcare program or customer service experience including budget management
- 3 years management/supervisory experience (or 3 years equivalent military experience E4+)
- Proficiency with Microsoft Office
- Strong organizational, analytical, presentation, and customer service skills
- Strong oral and written communication; proficient spelling, punctuation, grammar
- Ability to handle confidential or sensitive information with discretion
- Experience tracking performance metrics and implementing process improvements
- Ability to work onsite full-time with occasional overtime and travel between buildings
- Experience in FISS, MAS, PECOS, and HIGLAS
- Management experience in a Medicare Administrative Contractor operational setting
BlueCross BlueShield of South Carolina Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about BlueCross BlueShield of South Carolina and has not been reviewed or approved by BlueCross BlueShield of South Carolina.
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Healthcare Strength — The package includes multiple medical and dental plan options, free vision, company‑paid life insurance, and short‑/long‑term disability, plus wellness programs and an EAP. On‑site clinics and fitness centers at major locations complement core health coverage.
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Leave & Time Off Breadth — Paid time off starts at about four weeks per year alongside nine paid holidays. This provides substantial baseline leave from day one.
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Wellbeing & Lifestyle Benefits — Wellness discounts, coaching, and incentives are emphasized, with on‑site fitness resources where available. Additional tools and services support day‑to‑day wellbeing.
BlueCross BlueShield of South Carolina Insights
What We Do
For more than six decades, BlueCross BlueShield of South Carolina has been part of the national landscape. Our roots are firmly embedded in the state. We are the largest insurance company in South Carolina. We are also the only one that has an A+ Superior A.M. Best rating. We are one of the nation's leading government contract administrators. We operate one of the most sophisticated data processing centers in the Southeast and have a diverse family of subsidiary companies. Our full-time employees enjoy benefits like a 401(k) retirement savings plan with company match, subsidized health plans, free vision coverage, life insurance, paid annual leave and holidays, wellness programs and education assistance. If you are a full-time employee in the National Guard or reserves, we will cover the difference in your pay if you are called to active duty. BlueCross has a dedicated corporate culture of community support. Our employees are some of the most giving in the country. They support dozens of nonprofit organizations every year. If you're ready to join a diverse company with secure, community roots and an innovative future, apply for a position now!
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