Summary
Responsible for ensuring the prompt, appropriate and accurate distribution of case files and maintaining statistics on questionnaires, ROC06 claims and caseloads.
Description
Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, 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, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!
Position Purpose: Responsible for ensuring the prompt, appropriate and accurate distribution of case files and maintaining statistics on questionnaires, ROC06 claims and caseloads.
Location: This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-4:30PM. This role is located at 4101 Percival Road, Columbia, SC 29229.
Sponsorship: This position is not eligible for sponsorship now or in the future.
What You’ll Do:
Research positive questionnaires, activate RCN numbers and assign cases to claims adjusters accordingly.
Maintain statistics and prepare monthly reports concerning questionnaires, ROC06 claims, positive/negative questionnaire responses, assignment of cases, types of cases, and undelivered mail.
Open ITS ROC6 claims.
Prepare monthly and quarterly savings reports for cost containment and ASO accounts. Prepare monthly reports concerning assignment of cases and the quantity of work performed by adjusters.
Open non-ITS ROC06 claims.
Respond to accident reports from nursing department.
To Qualify for This Position, You'll Need the Following:
Required Education: Associate's
Degree Equivalency: 2 years of job related work experience
Required Work Experience: 1 year of experience in claims or customer service.
Required Skills and Abilities:
Analyzes laws, regulations and contract language
Evaluates issues and develops recommendations
Handles confidential and sensitive information
Investigates assigned claims
Proposes claims adjustments and refunds
Works claims caseloads
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
Education Assistance
Service Recognition
National 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.
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…