Claims & Appeals Specialist II

BlueCross and BlueShield of South Carolina; Columbia (SC); On-site; USD 36,000 - 48,000; Full time

Benefits offered by this job

Subsidized health plans

401K retirement savings plan with公司|匹配

Life Insurance

Paid Time Off (PTO)

On-site cafeterias and fitness centers

Wellness program and healthy lifestyle

Tuition assistance

Service recognition

Employee Assistance

Discounts to movies

Job summary

BlueCross BlueShield of South Carolina is seeking a full-time Claims Support role in Columbia. The position handles routine correspondence and telephone inquiries about claims or appeals, and identifies and reprocesses incorrectly processed claims.

The role is on-site at 17 Technology Circle, Columbia, with typical 8-hour shifts from 8:00 AM to 6:00 PM, Monday through Friday, and occasional overtime. US citizenship required for security clearance.

Qualifications

• High School Diploma or equivalent.
• 2 years of customer service experience OR 1 year of claims or appeals processing experience and 1 year of customer service experience OR Bachelor's Degree in lieu of work experience.
• Good verbal and written communication, strong customer service, and good spelling, punctuation and grammar.
• Basic business math proficiency.
• Ability to handle confidential or sensitive information with discretion.
• Microsoft Office proficiency.

Responsibilities

• Researches and responds to telephone inquiries according to desk procedures, ensuring timeliness, productivity, and quality.
• Research and respond to written inquiries and identify incorrectly processed claims and completes the adjustment and/or reprocessing action.
• Identifies complex inquiries and refers to a lead or manager; identifies potential fraud and abuse.
• Completes projects and/or assignments related to claims processing and customer service functions.

Skills

Communication

Customer service

Discretion

Math basics

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina is seeking a full-time Claims Support role in Columbia. The position handles routine correspondence and telephone inquiries about claims or appeals, and identifies and reprocesses incorrectly processed claims.

The role is on-site at 17 Technology Circle, Columbia, with typical 8-hour shifts from 8:00 AM to 6:00 PM, Monday through Friday, and occasional overtime. US citizenship required for security clearance.