Summary. Responsible for identifying training needs, developing training materials and facilitating training. Provides training, guidance and leadership for new training specialists. Develops performance assessments and testing materials. Manages trainees and communicates effectively with area management on trainee performance. Description. Location: This role works onsite schedule with remote opportunities reporting to 17 Technology Circle Colum...
Summary. Responsible for responding to customer inquiries. Inquiries may be non-routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures. Description. Why should you join the BlueCross BlueShield of South Carolina family o...
Summary. Responsible for responding to routine inquiries. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures. Description. 40% Responds to written and/or telephone inquiries according to desk procedures, ensuring that contract standards and obj...
Summary. Performs quality control audits to evaluate the accuracy and effectiveness of departmental operations functions, including claims, membership, benefit files, customer service/call center, workflow, processing support systems, procedures, documentation, etc. Identifies problems, analyzes cause and effect, and makes recommendations for improvements. Description. Logistics. This position is full-time (40 hours/week), Monday – Friday. This p...
Summary. Performs quality control audits to evaluate accuracy and effectiveness of departmental operations functions including, but not limited to, claims, membership, customer service/call center, workflow, processing support systems, procedures, documentation, etc. Identifies problems, analyzes cause and effect, and makes recommendations for improvements. Description. Position Purpose. We are currently hiring for a Sr Quality Assurance Analyst,...
Summary. We are currently hiring for a Claims Customer Service Manager to join BlueCross BlueShield of South Carolina. You will be performing routine but varied clerical duties in accordance with standard procedures. This includes clerical duties such as photocopying, compiling records, filing, tabulating, posting information, distributing mail, screening, scanning, data element verification and document indexing. Applies knowledge of department ...
Summary. 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 d...
Summary. Under general supervision, performs a variety of routine to moderately complex clerical/accounting functions such as inventory balancing, reconciliations, generating refund request letters, processing disbursements and deposits, keying journal entries and logging items in accordance with standard procedures in one or more of the following areas. general accounting, accounts payable, accounts receivable or related financial area. May comp...
