Summary
 

We are currently hiring for a Membership Auditor II to join BlueCross BlueShield of South Carolina. In this role you will be responsible for auditing group (small/large and complex) accounts to ensure premium payments and/or reimbursements are processed/reported in a timely/accurate manner as well as speaking directly with the client in the instance issues arise. Auditing subscriber accounts to ensure premium payments are within grace period. Resolving billing and payment problems and adjudicates insufficient and/or incorrect payments back to subscribers. Performing all cash management functions for the department. Assisting in training of employees with billing and account receivables. Serving as membership workleader, coordinator and/or trainer.

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 have 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 committed to the same philosophy, consider joining our team!

Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.

Description
 

Logistics

This position is full time (40 hours/week) Monday-Friday 8:00-4:30 EST at the Percival Road location.

What You Will Do:

• Audits large and complex accounts. Prepares monthly activity reporting for groups.
• Researches and resolves payment problems and edit errors. Serves as liaison between Billing, Finance, and Stop Loss teams.
• Reviews billing, delinquency, credit card payment, and membership reports as well as aged claims reporting. Identifies problems and recommends solutions to supervisor. May test and implement system changes. May assign work and monitor workload and quality rate of account administrators and/or other assigned staff.
• Processes refunds to subscribers. Prepares deposits of subscriber payments. Processes check-runs and writes member checks to cut reimbursements to subscribers. Processes refunds for misrepresentation files.
• Handles difficult customer inquiries. Communicates with agents, providers, financial institutions to resolve customer grievances. Responds accurately and timely to internal/external customers with regard to reporting and processing of premium payments and reimbursements.

To Qualify for This Position, You Will Need:

• Associate's OR 2 years job related work experience
• 3 years of experience in accounting, billing, audit/compliance, or a combination of these.
• Required Skills and Abilities: Knowledge of computer and reporting systems and files --- Membership, Billing, Accounting. Good judgment skills. Effective customer service, organizational, problem solving skills. Demonstrated verbal and written communication skills. Analytical or critical thinking skills. Ability to handle confidential or sensitive information with discretion.
• Required Software and Other Tools: Microsoft Office.

What We Prefer:

• One year of Membership, Billing, or Accounts experience.
• Knowledge of underwriting rules/regulations, benef