Unfortunately, this job posting is expired.
Don't worry, we can still help! Below, please find related information to help you with your job search.
Some similar recruitments
Mortgage Processor Ii Jobs
Recruited by Ascend Federal Credit Union 11 months ago Address Murfreesboro, TN, United States

Claims Processor Ii Jobs

Company

BlueCross BlueShield of South Carolina

Address Nashville, TN, United States
Employment type FULL_TIME
Salary
Category Insurance
Expires 2023-09-08
Posted at 9 months ago
Job Description
Summary


Position Purpose:


In the role as a Claims Processor II, the ideal candidate will be responsible for reviewing and adjudicating complex or specialty claims. One will determine whether to return, deny, or pay claims following organizational policies and procedures. The ideal candidate will also be able to assist in training or mentoring new staff members.


Description


Claims Processor II


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 a full-time position (40 hours per week) Monday through Friday 8:00 am CST – 4:30 PM CST. This position is open to remote candidates across the United States. Preference will be given to candidates in Nashville, TN and Columbia, SC. Candidates in these states will work on-site in a typical office environment if they reside 40 miles within the office location.


What You’ll Do


  • Correct processing errors by reprocessing, adjusting, and/or recouping claims
  • Verify that claims have been keyed correctly
  • Perform research on claim problems by utilizing policies, procedures, reference materials, forms, and coordinates with various internal support areas
  • Enter claims into the claim system after verification of correct coding of procedures and diagnosis codes
  • Examine and process complex or specialty claims according to business/contract regulations, internal standards and examining guidelines
  • Research and resolve claims edits and deferrals
  • Respond to routine correspondence and completes spreadsheet if applicable
  • Ensure that claims are processing according to established quality and production standards


To Qualify For This Position, You’ll Need


  • High School Diploma or equivalent
  • Proficient in spelling, punctuation, and grammar
  • Strong organizational, analytical and judgment skills
  • Proficient in basic business math
  • Ability to handle confidential or sensitive information with discretion
  • Strong oral and written communication skills
  • Microsoft Office
  • 2 years of experience processing, researching, and adjudicating claims


We Prefer That You Have


  • 5 years-of experience processing and adjudicating claims
  • Proficient in word processing and spreadsheet applications
  • Knowledge of mathematical and statistical concepts
  • Strong time management skills
  • Proficient database software skills


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.


  • 401K retirement savings plan with company match
  • Life Insurance
  • On-site cafeterias and fitness centers in major locations
  • Subsidized health plans, dental and vision coverage
  • Wellness program and healthy lifestyle premium discount
  • Tuition assistance
  • Employee Assistance
  • Paid Time Off (PTO)
  • Service recognition
  • Discounts to movies, theaters, zoos, theme parks and more


What To Expect Next


After submitting your application, our recruiting team members will review your resume to ensure your meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. If the qualifications require proof of semester hours, please attach your transcript to your application.


Management will be conducting interviews with the most qualified candidates, with prioritization given 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.


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 [email protected] or call 1-800-288-2227, ext. 43172 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.