Summary
 

Manages the daily activities of a multi-functional area. Responsible for monitoring productivity, attendance and quality of work produced. Responsible for motivating associates to meet individual and departmental goals.

You could be the one who changes everything for our members. BlueCross BlueShield is transforming the health of our communities, one person at a time. If you're ready to join a diverse company with secure, community roots and an innovative future, apply for a position now!

Description
 

Logistics:

This position is full-time (40-hours/week) Monday-Friday in a typical office environment. It may be necessary, given the business need to work occasional overtime. You may be required to travel between buildings. This role is located on-site at 8733 Highway 17 Bypass, Myrtle Beach, SC 29575 and provides a typical office work environment.

What You’ll Do:

• Direct and supervise claims/documents processing and support team associates to ensure claims/documents are processed in a timely and efficient manner to maintain contract compliance standards. Prepare and analyze reports of pending and processed documents, claims, adjustments and reprocesses, and quality audits of claims/documents that measure level of performance of the team. Administer and oversee quality control procedures and ensure compliance of all corporate and contract required guidelines. Select and maintain a well-trained staff. Identify potential education and system issues.

• Establish and maintain a high level of customer service with all internal and external customers. Direct and supervise the customer service associates to ensure that all correspondence and telephone inquiries are processed in a timely and efficient manner to maintain contract compliance standards. Select and maintain a well-trained staff. Identify potential education and system issues.

• Participate as project leader on policy changes, quality improvements initiatives and system change efforts, while ensuring corporate, contractor, and department policies and procedures are administered timely, consistently, and accurately. Identify system errors and process/quality improvement opportunities, initiate work requests, and serve as the customer project lead to ensure accurate implementation. 

• Assist in budget preparation and monitor expenses related to the budget.

To Qualify for This Position, You’ll Need:

• Bachelor's degree

• 3 years of job-related work experience, including either 1 year of supervisory experience OR 1-year equivalent military experience in grade E4 or above.

• Strong management, organization, communication, decision-making, and analytical skills.

• Excellent customer service skills.

• Strong presentation skills and basic business math proficiency.

• Knowledge of applicable laws and regulations pertaining to business unit operations.

• Microsoft Office.

What do we prefer:

• Preferred Work Experience: 3 years-of related health or managed care industry work experience. 1 year-of management experience OR 1 year of equivalent military experience in grade E4 or above.

• Ability to use complex mathematical calculations.

• Knowledge of mathematical or statistical concepts.

• Proficient in database software.

What We can Do for You: