What are the responsibilities and job description for the Claims Customer Service Supervisor position at CGS Administrators, LLC?
Summary
We are currently hiring for a Claims Customer Service Supervisor to join CGS/BlueCross BlueShield of South Carolina. In this role as a Claims Customer Service Supervisor, you will be responsible for supervising a team of employees responsible for claims, appeals, and/or customer service to ensure contractual and departmental performance guarantees are met. You will be responsible for recruiting and hiring, coaching and mentoring, monitoring and evaluation, and addressing all disciplinary issues in a timely manner.
Why should you join the CGS and our parent company BlueCross BlueShield of South Carolina family? 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!
Description
Logistics:
This position is full time (40 hours/week) Monday-Friday in a typical office environment. Employees are required to work our Monday – Friday 8-hour shift scheduled during hours of 8:00 AM – 5:00 PM. Training will be Monday – Friday 8:00 AM – 5:00 PM for approximately 6-8 weeks. This role is located on-site at 26 Century Blvd Suite ST610, Nashville, TN 37214.
Centers for Medicare and Medicaid Services (CMS) Requirements: Certain divisions within BlueCross BlueShield of South Carolina require CMS (Centers for Medicare and Medicaid Services) residency that requires employees to have lived in the US for at least three (3) out of the last five (5) years. This is a business requirement – government contracts, not an HR requirement.
What You Will Do:
Our comprehensive benefits package includes:
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.
We are currently hiring for a Claims Customer Service Supervisor to join CGS/BlueCross BlueShield of South Carolina. In this role as a Claims Customer Service Supervisor, you will be responsible for supervising a team of employees responsible for claims, appeals, and/or customer service to ensure contractual and departmental performance guarantees are met. You will be responsible for recruiting and hiring, coaching and mentoring, monitoring and evaluation, and addressing all disciplinary issues in a timely manner.
Why should you join the CGS and our parent company BlueCross BlueShield of South Carolina family? 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!
Description
Logistics:
This position is full time (40 hours/week) Monday-Friday in a typical office environment. Employees are required to work our Monday – Friday 8-hour shift scheduled during hours of 8:00 AM – 5:00 PM. Training will be Monday – Friday 8:00 AM – 5:00 PM for approximately 6-8 weeks. This role is located on-site at 26 Century Blvd Suite ST610, Nashville, TN 37214.
Centers for Medicare and Medicaid Services (CMS) Requirements: Certain divisions within BlueCross BlueShield of South Carolina require CMS (Centers for Medicare and Medicaid Services) residency that requires employees to have lived in the US for at least three (3) out of the last five (5) years. This is a business requirement – government contracts, not an HR requirement.
What You Will Do:
- Leads claims and customer service staff to ensure prompt and accurate settlement of claims, appeals, and/or customer service inquiries.
- Coordinates with other areas while establishing and maintaining excellent customer relations.
- Analyze problems and concerns to make effective decisions that provide positive solutions.
- Make recommendations for process improvements and efficiencies for the department.
- Responsible for recruiting and hiring, coaching and mentoring, monitoring and evaluation, and addressing all disciplinary issues in a timely manner.
- Encourage staff in creating and maintaining a work environment with high morale and employee satisfaction through support of professional development, training, career growth, and rewarding high performance.
- Serves as a liaison for internal and external customers.
- Ensures the timely and accurate resolution of any issues and/or provides necessary training to staff as needed or requested.
- Bachelor's
- 4 years job related work experience or Associate's and 2 years job related work experience
- 2 years of claims/appeals, customer service, or call center experience.
- Strong analytical, organizational, and judgment skills.
- Excellent customer service skills.
- Ability to persuade, negotiate or influence.
- Strong oral and written communication skills.
- Strong spelling, punctuation, and grammar skills.
- Demonstrated leadership ability.
- Microsoft Office.
- Bachelor's degree
- 4 years-of healthcare, customer service, or claims experience.
- Previous budget experience including durable medical equipment and supplies.
- 2 years or more of leadership experience including coordinating work of others, developing work procedures and training for others, and/or leading group project initiatives.
- Strong presentation skills.
- Basic business math skills.
- Ability to interact easily with customers, staff, and other members of the organization.
- Knowledge of the benefit plans for each group.
- Knowledge of all systems and their roles in claims adjudication.
- Strong leadership skills to direct and motivate employees.
- Knowledge of performance standards and quality assurance guidelines.
- Typical office environment.
- 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
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
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.
