Coordinator Claims Customer Service

Description:

Position Purpose:
In the role as the Claims Customer Service Coordinator, the ideal candidate will have the ability to research complex issues as well as being detailed-oriented. The ideal candidate also functions as a work leader for a claims customer service unit responsible for resolving customer inquiries and performing initial claims adjudication or non-medical appeals review. The Claims Customer Service Coordinator also assists with escalated issues.

Claims Customer Service Coordinator

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!

Logistics:

This position is full-time position (40 hours per week) Monday through Friday 8:30am – 5:00pm reporting onsite to 1000 Executive Center Drive, Greenville, SC 29615.

What You’ll Do:

• Distribute daily work to employees and track workload and employee performance

• Make appropriate decisions necessary to ensure all processing expectations and team goals are met

• Respond accurately and timely to inquiries from team members, including management, concerning customer inquiries, claims adjudication, appeals and other technical issues

• Investigate and initiate resolutions to complex problems

• Authorize payment recovery, claim payments, or make claim rejections based on documented information and provisions of state or federal law

• Identify issues with procedures and processes and provide feedback to management on changes and development

• Train new employees and introduce new material to all employees

• Develop, update, and maintain procedural manuals

• Serve 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’ll Need:

• High School Diploma or equivalent

• Three 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

What We can Do for You:

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

• Wellness program and healthy lifestyle premium discount

• Tuition assistance

• Service recognition

• Employee Assistance

• Discounts to movies, theaters, zoos, theme parks and more