Technician, Reimbursement

Southcarolinablues; Columbia, Northern (SC, KY); Hybrid; USD 45,000 - 65,000; Full time

Benefits offered by this job

Health plans

401k with company match

Life Insurance

PTO

On-site cafeterias and fitness centers

Education Assistance

Job summary

BlueCross BlueShield of South Carolina is seeking a Pricing/Claims Analyst to support pricing deferrals and analyze claims data to establish state prevailings. The role involves updating fee schedules, calculating prepayment pricing, and reviewing post-payment information.

You will work with reimbursement teams, coordinate with other areas on pricing inquiries, and maintain pricing file documentation to ensure accurate, verifiable pricing for procedures with non-established rates.

Qualifications

• High School Diploma or Equivalent.
• 2 years of related claims, healthcare, or customer service experience.

Responsibilities

• Responsible for handling pricing deferrals and analyzing claims data to establish state prevailings.
• Assists in updating fee schedules and in the review/validation for routine pricing updates.
• Calculates prepayment pricing information and accurate and verifiable pricing for procedures with non-established rates.
• Reviews claims for post payment information.
• Assists in departmental issues with the reimbursement program.
• Communicates with other areas regarding pricing problems and inquiries.
• Maintains all pricing file documentation for reference and future pricing.

Skills

Pricing analysis

Claims data analysis

Communication

Education

High School Diploma or Equivalent

Job description

Summary Responsible for handling pricing deferrals, analyzing claims data to establish state prevailings, and answering questions from other associates on pricing issues.

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!

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

BlueCross BlueShield of South Carolina - About Us | BlueCross BlueShield of South Carolina

Location: This position is full-time (40-hours/week) Monday-Friday in typical office environment. You will work an 8-hour shift, 8:00AM – 4:30PM. This role is located onsite at 4101 Percival Road, Columbia, SC 29229.

What You’ll Do:

• Responsible for handling pricing deferrals and analyzing claims data to establish state prevailings.
• Assists in updating fee schedules and in the review/validation for routine pricing updates.
• Calculates prepayment pricing information and accurate and verifiable pricing for procedures with non-established rates.
• Reviews claims for post payment information.
• Assists in departmental issues with the reimbursement program.
• Communicates with other areas regarding pricing problems and inquiries.
• Maintains all pricing file documentation for reference and future pricing.

To Qualify for This Position, You’ll Need the Following:

• High School Diploma or Equivalent
• 2 years of related claims, healthcare, or customer service experience.

Our Comprehensive Benefits Package Includes The Following:

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
• 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 basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

Veterans Welcome!

BlueCross is a strong supporter of our veterans, and many service men and women have joined our ranks. We’ve found the dedication, work ethic and job skills that serve well in the military excel in many of our lines of business, and we proudly have veterans filling positions in Human Resources, Information Technology, Customer Service, Operations, General Services and more. Through our government contracts, we also have employees serving at Shaw Air Force Base, the Naval Health Clinic in Charleston, the Naval Hospital in Beauport and in our hometown of Columbia, S.C., at Ft. Jackson. If you are a full-time employee in the National Guard or Reserves, we will even cover the difference in your pay if you are called to active duty.