Summary
 

As a Supervising member of the Claims Customer Service Team, you will manage supervising a team of employees responsible for claims, appeals, and/or customer service to ensure contractual and departmental performance guarantees are met.

Description
 

Logistics:

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 11:30am-8:00pm est. You may be required to travel between buildings. This role is located at 4101 Percival Road, Columbia, SC 29203 and provides a typical office work environment. It may be necessary, given the business needs, to work occasional overtime.

What You’ll Do:

• Ensure prompt and accurate settlement of claims, appeals, and/or customer service inquiries. Coordinates with other areas while establishing and maintaining excellent customer relations.
• Analyze problems and concerns to make effective decisions that provide positive solutions. Make recommendations for process improvements and efficiencies for the department.
• Serves as a liaison for internal and external customers. Ensures the timely and accurate resolution of any issues and/or provides necessary training to staff as needed or requested.

To Qualify for This Position, You’ll Need:

• Bachelor's degree or 4 years of healthcare experience in customer service, provider network service, membership, billing, and/or claims/appeals processing operations OR Four years of healthcare experience in customer service, provider network service, membership, billing, and/or claims/appeals processing operations.
• Two (2) years of claims/appeals, customer service, or call center experience.
• Answers phones
• Follows policies and procedures.
• Navigates systems.
• Processes claims.
• Research inquiries
• Reviews claims and appeals.
• Microsoft Office.

What we Prefer:

• 4 years-of healthcare, customer service, or claims experience.
• Previous budget experience.
• 1 year-of leadership experience including scheduling or coordinating work of others, developing work procedures and training for others, and/or leading group project initiatives.
• Strong presentation skills. Basic business math skills.
• Ability to interact easily with customers, staff, and other members of the organization. Knowledge of the benefit plans for each group.
• Knowledge of all systems and their roles in claims adjudication.
• Strong leadership skills to direct and motivate employees.
• Knowledge of performance standards and quality assurance guidelines

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

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 c