Director, Claims Customer Service

BlueCross BlueShield of South Carolina•Augusta, GA

1d•Onsite

About The Position

Logistics: Palmetto GBA – one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is full-time (40-hours/week) Monday-Friday in a typical office environment. This role is located at 2743 Perimeter Parkway, Augusta, GA 30909. Position Purpose: The Director of Claims Customer Service leads customer service, claims processing, and appeals operations to ensure timely, accurate service while driving initiatives that improve provider and customer satisfaction. This role oversees performance management, process improvements, system enhancements, and team development while supporting strategic goals and ensuring effective resource and budget management.

Requirements

Bachelor's Degree
4 years job related work experience or Associate's and 2 years job related work experience (Equivalency not applicable for the Celerian Group. Bachelor's degree required.)
7 years of healthcare program or customer service experience to include budget management experience including 3 years of management/supervisory experience OR 3 years of equivalent military experience in grade E4 or above (may be concurrent).
Strong organizational, analytical, presentation, and customer service skills.
Strong oral and written communication skills.
Ability to persuade, negotiate or influence.
Ability to handle confidential or sensitive information with discretion.
Proficient spelling, punctuation, grammar, and basic business math.
Microsoft Office.

Responsibilities

Directs customer service, claims processing, and/or appeals staff in ensuring prompt and accurate processing of items and inquiries.
Develops and supports strategic initiatives to enhance provider and customer satisfaction.
Works closely with areas to track performance and develop measures of success.
Implements process improvements.
Identifies system limitations and serves as project leader on system enhancements and updates.
Leads and supports achievement of departmental, divisional, and corporate strategic objectives.
Collaborates with other functional areas to resolve multi-functional issues.
Provides necessary assistance and resources when necessary.
Develops and monitors budget and resources for all assigned areas.
Responsible for the selection, training, and development of staff.
Ensures excellent customer service is given to employees, customers, management, etc.