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
 

• 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.
• Required Education:
• High School Diploma or equivalent
• Required Work Experience:
• 4 years of experience processing, researching and adjudicating claims.
• Required Skills and Abilities:
• Strong organizational, analytical and problem-solving skills.
• Strong verbal and written communication skills.
• Strong interpersonal and time-management skills.
• Strong spelling, punctuation and grammar skills.
• Basic business math proficiency.
• Ability to handle confidential or sensitive information with discretion.
• Required Software and Tools:
• Microsoft Office.
• Preferred Education:
• Associate Degree
• Preferred Skills and Abilities:
• Knowledge of mathematical or statistical concepts.
• Ability to persuade, negotiate or influence.
• Preferred Software and Other Tools:
• Proficient in database software.
• Work Environment:
• Typical office environment.

 

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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.