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.

You could be the one who changes everything for our members. BlueCross BlueShield is transforming the health of our communities, one person at a time. If you're ready to join a diverse company with secure, community roots and an innovative future, apply for a position now!

Description
 

Logistics:

This position is full-time (40-hours/week) Monday-Friday in a typical office environment. It may be necessary, given the business need to work occasional overtime. You may be required to travel between buildings. This role is located on-site at 8733 Highway 17 Bypass, Myrtle Beach, SC 29575 and provides a typical office work environment.

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.

• Microsoft Office.

What do we prefer:

• Preferred Work Experience: 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.

What We can Do for You:

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

• 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 your meet the qualifications.  This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. If the qualifications required proof of semester hours, please attach your transcript to your application.

Management will be conducting interviews with the most qualified candidates, with prioritization give 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.