Claims Coordinator

Summary

Provides intake support for the claims department. Works with a team to coordinate communications and ensure emails are reviewed, assigned or responded to timely. Reviews claim submissions for accuracy and loads them into the claims system. Checks the status of claims and provides customer service to clients and partners.

• Experience with stop loss, third party administrator or medical claims preferred.

Description Location: This is a full-time position working (40-hours/week) Monday-Friday 8:00am – 5:00pm working remotely. Position Purpose: Provides claims support by reviewing submissions, entering claims, tracking status, and responding to client and partner inquiries. Experience with stop loss, TPA, or medical claims preferred. What You’ll Do:

• Processes mail, email and faxes to maintain departmental productivity, quality and timeliness standards. May assist in preparing various financial data associated with refunds, recoupments, adjustments, and reissues, and ensure appropriate documentation for each refund request and associated payment. Maintains logs. Assists in processing/providing routine premium billing statements and/or various reports. Maintains filing systems.
• Coordinates communication of information between reinsurance companies and various internal and external areas. Reviews documentation for completeness, and may rate new business, order required reports within timeliness standards, determine benefits, issue new policies, and/or report surplus lines taxes. Requests additional information when needed within timeline standards. Accurately documents process changes.
• Checks status of claims or notices, and may service existing accounts by processing endorsements/amendments, identifying problems, and responding to inquiries. May review disbursement requests for large case management claims and other specific diagnosis codes, and forward to claims for detailed review.
• Ensures effective customer relations by responding accurately, timely, and courteously to telephone or written customer inquiries. Accurately documents inquiries.

To Qualify for This Position, You Will Need

• Required Education: High School Diploma or equivalent.
• Required Experience: 1 year customer service or administrative experience.
• Required Skills and Abilities: Excellent verbal and written communication skills. Good human relations skills. Strong research ability. Ability to function in a high-pressure environment with minimum supervision. Ability to handle confidential or sensitive information with discretion. Strong organizational skills. Proven customer service skills. Good judgment. Proficient spelling, punctuation, grammar, and basic math skills.
• Required Software and Tools: Microsoft Office.

We Prefer That You Have:

• Preferred Education: Associate degree-Business Administration or related field
• Preferred Work Experience: 2 years-customer service, operations support, or underwriting experience.

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 communication with our recruiter to verify resume specifics and salary requirements. If the qualifications required proof of semester hours, please attach your transcript to your application. 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 company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email [email protected] or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information. Some states have required notifications. Here's more information. Apply tot his job Apply To this Job