Lead Claims Processor - CGS Administrators

Summary
 Functions as the team lead and subject-matter expert for a claims area. Responsible for creating reports, distributing workload and training new employees.
Description
 

CGS is now hiring full-time work Lead Claims Processor with a competitive starting salary in the government healthcare industry.

CGS Administrators, LLC – “We IMPACT Lives.” Is our mission which ties directly into our company’s vision.  “To IMPACT the future of our communities and nation by being the premier administrator of government healthcare programs.”

A day in the life of a CGS Lead Claims Processor :

Functions as the team lead and subject-matter expert for a claims area. Responsible for creating reports, distributing workload and training new employees.

This position can be remote if applicable.

(more than 50miles from building location)

Work hours: Can be flexible with start and end times.

What You'll Do:

• Responds accurately and timely to inquiries from team members, including management, concerning claims processing and other technical issues. Investigates and initiates resolutions to complex claims problems
• Trains and assists new employees and unit personnel to ensure consistent application of established guidelines
• Identifies issues with procedures and processes and provides feedback to management on changes and development.
• Serves as liaison with other departments to address claim, system and quality issues. May perform some testing functions and attend/participate in meetings as needed.

To Qualify for This Position, You'll Need:

• High School Diploma or equivalent
• 4 years of experience processing, researching and adjudicating claims.

• Strong analytical, organizational and customer service skills.
• Strong oral and written communication skills.
• Proficient spelling, punctuation and grammar skills.
• Good judgment skills.
• Basic business math skills.
• Ability to handle confidential or sensitive information with discretion.
• Microsoft Office

We Prefer That you have:

• Associate Degree
• Knowledge of mathematical or statistical concepts. Ability to persuade, negotiate or influence.
• Proficient in database software.

• Ability to use complex mathematical calculations.

• Proficient in database software.

• Typical office environment.

Our comprehensive benefits package includes:401(k)

• 401K
• Dental, Vision, Health and Life insurance
• Paid annual leave, 11.5 hours of paid time off (PTO) per month
• 9 paid holidays
• Wellness programs and a healthy lifestyle health insurance premium discount
• Tuition assistance
• Service recognition

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

Some states have required notifications. Here's more information. 

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 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 [email protected] or call 1-800-288-2227, 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.