Summary
Manages the daily activities of a multi-functional area. Responsible for monitoring productivity, attendance and quality of work produced. Responsible for motivating associates to meet individual and departmental goals.
Description
What You'll Do:
- Direct and supervise claims/documents processing and support team associates to ensure claims/documents are processed in a timely and efficient manner to maintain contract compliance standards.
- Prepare and analyze reports of pending and processed documents, claims, adjustments and reprocesses, and quality audits of claims/documents that measure level of performance of the team.
- Administer and oversee quality control procedures and ensure compliance of all corporate and contract required guidelines.
- Select and maintain a well-trained staff. Identify potential education and system issues.
- Establish and maintain a high level of customer service with all internal and external customers. Direct and supervise the customer service associates to ensure that all correspondence and telephone inquiries are processed in a timely and efficient manner to maintain contract compliance standards. Select and maintain a well-trained staff. Identify potential education and system issues.
- Participate as project leader on policy changes, quality improvements initiatives and system change efforts, while ensuring corporate, contractor, and department policies and procedures are administered timely, consistently and accurately. Identify system errors and process/quality improvement opportunities, initiate work requests, and serve as the customer project lead to ensure accurate implementation.
- Assist in budget preparation and monitor expenses related to the budget.
To Qualify for This Position, You'll Need:
- Bachelor's Degree.
- 3 years of job-related work experience, including either 1 year of supervisory experience OR 1-year equivalent military experience in grade E4 or above.
- Strong management, organization, communication, decision-making, and analytical skills.
- Excellent customer service skills. Strong presentation skills and basic business math proficiency.
- Knowledge of applicable laws and regulations pertaining to business unit operations.
- Proficient in Microsoft Office Products.
- Ability to work in a typical office environment and travel as needed.
We Prefer You to Have:
- 3 years-of related health or managed care industry work experience.
- 1 year-of management experience OR 1 year of equivalent military experience in grade E4 or above.
- Ability to use complex mathematical calculations.
- Knowledge of mathematical or statistical concepts.
- Proficient in database software.
- Typical office environment. Ability to travel as needed.
What Blue 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.
Our comprehensive benefits package includes:
- 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.
- Wellness program and healthy lifestyle premium discount.
- Tuition assistance.
- Service recognition.
- Employee Assistance.
- Discounts to movies, theaters, zoos, theme parks and more!
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.
Management will be conducting interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications.
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.
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.
Top Skills
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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