Technical Information Specialist

BlueCross BlueShield of South Carolina•Florence, SC

2d•Hybrid

About The Position

We are currently hiring for a Technical Information Specialist to join BlueCross BlueShield of South Carolina. In this role as a Technical Information Specialist, you will be responsible for the maintenance of records and the processing of claims in medical review, along with any and/or all of the following: processes ingoing/outgoing mail and prepares work for nursing staff, you will troubleshoot claims prior to nurse review and after review, monitor timeliness of claims processing and adjusts claims keyed incorrectly, and perform quality control of work processes. Description Location This position is full-time (40 hours/week) Monday-Friday from 8:00am-5:00pm EST and will be hybrid in Florence, SC. What You’ll Do: Processes denials of claims. Processes adjustment claims for both pre-pay and post-pay departments. Investigates and analyzes adjustment claim history and denial records. Prescreens records for review and maintains accurate records of all claims. Communicates with provider community and assists provider service department in responding to inquiries. Generates educational correspondence to providers regarding denials. Performs quality control of work processes. Assists manager with special projects.

Requirements

Associate's degree
2 years of job-related work experience
1 year of administrative/clerical support.
Working knowledge of word processing software.
Strong analytical, organizational, and customer service skills.
Strong verbal and written communication skills.
Proficiency in spelling, punctuation, and grammar skills.
Good judgment skills.
Ability to handle confidential or sensitive information with discretion.
Microsoft Office.

Responsibilities

Processes denials of claims.
Processes adjustment claims for both pre-pay and post-pay departments.
Investigates and analyzes adjustment claim history and denial records.
Prescreens records for review and maintains accurate records of all claims.
Communicates with provider community and assists provider service department in responding to inquiries.
Generates educational correspondence to providers regarding denials.
Performs quality control of work processes.
Assists manager with special projects.