Lead Claims Processor

Logistics:

National Alliance - is a subsidiary company of BlueCross BlueShield of South Carolina.

Location:

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 -5:00 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 200 North Dozier Boulevard, Florence SC 29501

What You'll Do:

• Responds accurately and timely to inquiries from team members, including management, concerning claims processing and other technical issues. Investigates and initiates resolutions to complex claims problems.
• Trains and assists new employees and unit personnel to ensure consistent application of established guidelines.
• Identifies issues with procedures and processes and provides feedback to management on changes and development.
• 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'll Need the Following:

• Required Education:
• High School Diploma or equivalent
• Required Work Experience:
• 4 years of experience processing, researching and adjudicating claims.
• Required Skills and Abilities:
• Strong organizational, analytical and problem-solving skills.
• Strong verbal and written communication skills.
• Strong interpersonal and time-management skills.
• Strong spelling, punctuation and grammar skills.
• Basic business math proficiency.
• Ability to handle confidential or sensitive information with discretion.
• Required Software and Tools:
• Microsoft office

We Prefer You Have the Following:

• Associate degree.
• Knowledge of mathematical or statistical concepts.
• Ability to persuade, negotiate and influence.
• Proficient in database software.
• ITS/Blue2 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 for 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

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.

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 our recruiter to verify resume specifics and salary requirements.

Management will conduct interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the required qualifications.

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 disabilitiesand 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 mycareer.help@bcbssc.comor 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. Here's moreinformation.

Some states have required notifications. Here's more information.