Recovery Coordinator

BlueCross and BlueShield of South Carolina; Columbia (SC); On-site; USD 42,000 - 58,000; Full time

Benefits offered by this job

Subsidized health plans

401k retirement savings with company  

Life Insurance

Paid Time Off (PTO)

On-site cafeterias and fitness centers

Education Assistance

Service Recognition

National discounts

Job summary

BlueCross BlueShield of South Carolina is seeking a professional to ensure prompt, accurate distribution of case files and to maintain statistics on questionnaires and ROC06 claims. This full-time role is based in Columbia, SC, in a typical office environment.

You will open ROC6 claims, prepare monthly and quarterly reports, and support cost containment initiatives while handling sensitive information with discretion during standard business hours.

Qualifications

• Analyzes laws, regulations and contract language.
• Evaluates issues and develops recommendations.
• Handles confidential and sensitive information.
• Investigates assigned claims.
• Proposes claims adjustments and refunds.
• Works claims caseloads.

Responsibilities

• Research positive questionnaires, activate RCN numbers and assign cases to claims adjusters accordingly.
• Maintain statistics and prepare monthly reports concerning questionnaires, ROC06 claims, positive/negative questionnaire responses, assignment of cases, types of cases, and undelivered mail.
• Open ITS ROC6 claims.
• Prepare monthly and quarterly savings reports for cost containment and ASO accounts. Prepare monthly reports concerning assignment of cases and the quantity of work performed by adjusters.
• Open non-ITS ROC06 claims.
• Respond to accident reports from nursing department.

Skills

Analyzes laws and contract language

Evaluates issues and recommendations

Confidential information handling

Investigates claims

Proposes claim adjustments

Works claims caseloads

Education

Associate's

Degree Equivalency: 2 years of work experience

Job description

Summary

Responsible for ensuring the prompt, appropriate and accurate distribution of case files and maintaining statistics on questionnaires, ROC06 claims and caseloads.

Description

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!

Position Purpose: Responsible for ensuring the prompt, appropriate and accurate distribution of case files and maintaining statistics on questionnaires, ROC06 claims and caseloads.

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 8:00AM-4:30PM. This role is located at 4101 Percival Road, Columbia, SC 29229.

Sponsorship

This position is not eligible for sponsorship now or in the future.

What You'll Do

• Research positive questionnaires, activate RCN numbers and assign cases to claims adjusters accordingly.
• Maintain statistics and prepare monthly reports concerning questionnaires, ROC06 claims, positive/negative questionnaire responses, assignment of cases, types of cases, and undelivered mail.
• Open ITS ROC6 claims.
• Prepare monthly and quarterly savings reports for cost containment and ASO accounts. Prepare monthly reports concerning assignment of cases and the quantity of work performed by adjusters.
• Open non-ITS ROC06 claims.
• Respond to accident reports from nursing department.

To Qualify for This Position, You'll Need the Following

Required Education: Associate's

Degree Equivalency: 2 years of job related work experience

Required Work Experience: 1 year of experience in claims or customer service.

Required Skills and Abilities

• Analyzes laws, regulations and contract language
• Evaluates issues and develops recommendations
• Handles confidential and sensitive information
• Investigates assigned claims
• Proposes claims adjustments and refunds
• Works claims caseloads

Our Comprehensive Benefits Package Includes the Following

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits for 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.

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 [e-mail] 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