Claims Technician

PGBA,•Florence, SC

5d•Onsite

About The Position

Summary We are currently hiring for a Claims Customer Service Manager to join BlueCross BlueShield of South Carolina. You will be performing routine but varied clerical duties in accordance with standard procedures. This includes clerical duties such as photocopying, compiling records, filing, tabulating, posting information, distributing mail, screening, scanning, data element verification and document indexing. Applies knowledge of department policies and procedures and utilizes a general understanding of other departments' functions. Maintains records, prepares forms, verifies information and resolves routine problems. Ensures claims are processed in a timely manner. 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’ve 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 dedicated 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: PGBA – one of BlueCross BlueShield's South Carolina subsidiary companies Location: This position is full-time (40-hours/week) Monday-Friday from 8:00am-5:00pm in a typical office environment. This role is located on-site at 200 North Dozier Boulevard Florence, SC 29501. Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). Under the McNamara-O'Hara Service Contract Act (SCA), employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date. What You’ll Do:

Requirements

High School Diploma or equivalent
Strong organizational and analytical skills.
Good communication and organizational skills.
Detail-oriented.
Ability to handle confidential or sensitive information with discretion.

Nice To Haves

Ability to accurately key 5000 ksph or 30 wpm.
Knowledgeable in word processing and spreadsheet applications.

Responsibilities

Receives, opens, sorts and distributes incoming departmental mail or work requests.
Checks workflow documents to ensure required information is available.
Requests any missing documentation as needed.
Scans all documents for storage in the electronic repository.
Prepares correspondence or packages for internal/external mailing.
Screens and verifies information.
Ensures proper and accurate processing flow of all paper claims and correspondence in accordance with department standards for quality and production, contract regulations, policies and guidelines.
Conducts data element verification of data elements for those that fail the mapping process prior to claims adjudication.
Applies appropriate indexes as needed to claims and/or correspondence.
Maintains departmental logs, spreadsheets or databases.
Effectively uses all available reference materials in performance of daily functions.
Keeps track of supply inventory and/or orders supplies as needed.