Summary
 

Responsible for overseeing an area responsible for the timely and comprehensive investigation and processing of assigned claims.

Description
 

• Ensure the timely processing and adjudication of all claims.
• Interviews and/or assists in the selection of staff.
• Performs quality control reviews and/or monitor performance of staff to ensure appropriate understanding and utilization of applicable laws, contract policies, and procedures.
• Monitors production and timeliness of work and maintains desk procedures.
• Establish and maintain a strong working relationship with all internal and external customers.
• Required Education:
• Bachelor's Degree or equivalency of 4 years job related work experience or Associate's and 2 years job related work experience.
• Required Work Experience:
• 1 year of claims processing experience. 1 year of lead experience and may be concurrent.
• Required Skills and Abilities:
• Strong organizational, leadership, decision making, analytical, problem solving, interpersonal and time management skills.
• High-level knowledge of claims processing and related support and the ability to handle confidential or sensitive information with discretion.
• Required Software and Tools:
• Proficient in Microsoft Office Products including Outlook, Word, Excel, and Power Point.
• Preferred Education:
• Bachelor's degree-in Business Management or Administration.
• Preferred Work Experience:
• 6 years-of claims processing experience.
• Previous supervisory experience or equivalent military experience in grade E4 of above
• Preferred Skills and Abilities:
• Strong presentation skills.
• Work Environment:
• Typical office environment. Ability to travel as needed.

 

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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 c