Summary
Manages a team of associates responsible for the accurate and timely processing and adjudication of claims.
Description
Logistics: Palmetto GBA – one of BlueCross BlueShield's South Carolina subsidiary companies.
Location: This position is 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 8:30AM-5:30PM. This role is located at 2743 Perimeter Parkway, Augusta, GA 30909.
What You’ll Do:
Monitors and evaluates one or more units to ensure the accurate and timely processing of claims. Develops effective claims processing standards that incorporate the use of automated claims systems and other technology solutions.
Ensures compliance with all applicable laws, regulations, and contract requirements while meeting performance expectations.
Monitors all reports and quality audits to ensure the efficient operation of the department. Ensures proper training for new and current staff.
Maintains a high level of customer service with all internal and external customers. Interacts regularly with internal departments for planning, training, and management purposes.
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:4 years of claims processing experience, including either 2 years of lead or supervisory experience OR 2 years of equivalent military experience in grade E4 or above
Required Skills and Abilities:
Analyzes claims deferrals
Diagnoses claims issues
Enters claims data
Reviews work from others
Uses sound reasoning when processing claims
We Prefer That You Have The Following:
Preferred Software and Other Tools: Microsoft Office.
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.
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!
