Claims Customer Service Coordinator

BlueCross BlueShield of South Carolina
life insurance, paid holidays, tuition assistance, 401(k)
United States, South Carolina, Columbia
Jan 02, 2025
Summary We are currently hiring for a Claims Customer Service Coordinator to join BlueCross BlueShield of South Carolina. You will be responsible for resolving customer inquiries and performing initial claims adjudication or non-medical appeals review. You will also assist with escalated and complex issues. Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we've been part of the national landscape, 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 that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future. Description Logistics: This position is full time (40 hours/week) Monday-Friday in a typical office environment. Employees are required to have flexibility work any our 8-hour shift scheduled during hours of 8:00 AM - 6:00 PM. Training will be Monday - Friday 8:00 AM -4:30/5:00 PM for approximately 6-8 weeks. *This role is located on-site at 4101 Percival Road, Columbia SC* What you will do: Distributes daily work to employees, tracks workload and employee performance, and makes appropriate decisions necessary to ensure all processing expectations and team goals are met. Responds accurately and timely to inquiries from team members, including management, concerning customer inquiries, claims adjudication, appeals and other technical issues. Investigates and initiates resolutions to complex problems. Authorizes payment recovery, claim payments, or makes claim rejections based on documented information and provisions of state or federal law. Identifies issues with procedures and processes and provides feedback to management on changes and development. Trains new employees and introduces new material to all employees. Develops, updates, and maintains procedural manuals. 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. To Qualify for this position, you will need: High School Diploma or equivalent 3 years of customer service experience and 1 year of claims or appeals processing experience OR Bachelor's Degree in lieu of work experience. Excellent verbal and written communication skills. Strong customer service skills. Proficient spelling, punctuation, grammar, and basic business math. Ability to handle confidential or sensitive information with discretion. Knowledge of claims processing procedures. Microsoft Office. Work Environment: Typical office environment. You are not alone. We are here to support you with: Classroom and Lab Training Best in class call center training program A classroom environment, live trainer, and open discussion A proven curriculum providing the knowledge you need to excel A training lab where you take live calls with a training supervisor close by to answer questions What We Can Do for You: Our comprehensive benefits package includes: 401(k) retirement savings plan with company match Subsidized health plans and free vision coverage Life insurance Paid annual leave - the longer you work here, the more you earn Nine paid holidays On-site cafeterias and fitness centers in major locations Wellness programs and healthy lifestyle premium discount Tuition assistance Service recognition What to Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and salary requirements. 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 mycareer.help@bcbssc.com 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.