Stop Loss Coordinator

BlueCross BlueShield of South Carolina•San Francisco, CA

About The Position

Provides reinsurance support for new and renewal business, underwriting, claims audit/record keeping and/or other functions. May perform calculations and process general accounting requests for billing or payments, and/or check the status of claims and process policy changes. Provides customer service to clients and partners. Runs reports as needed. Description Why Should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina.. and much more. We are on of the nations 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, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Position Purpose: Provides reinsurance support for new and renewal business, underwriting claims audit/record keeping.and/or other functions. May perform calculations and process general accounting requests for billing or payments, and/or check the status of claims and process policy changes. Provides customer service clients and partners. Runs reports as needed. What You Will 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.

Requirements

High School Diploma or equivalent.
1 year customer service or administrative experience.
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.
Microsoft Office.

Nice To Haves

Associate Degree-Business Administration or related field.
2 years-customer service, operations support, or underwriting support.

Responsibilities

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.