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Claims & Adjustment Specialist
3 months ago
At Blue Cross & Blue Shield of Mississippi, we encourage professional growth in a challenging and fast-paced atmosphere. Our 'be healthy' culture promotes health and wellness at all levels of the Company, and we provide our employees with the time, tools and resources to commit to a healthy lifestyle.
The The Claims & Adjustments Specialist is responsible for maintain inventories which focus on the accurate and timely processing of member claim as well as member and provider inquiries. The Claims & Adjustments Specialist will process fully insured group, fully insured non-group and self insured in-state and out-of-area claims for Mississippi members. The Claims & Adjustments Specialist is also responsible for handling member and provider inquiries and inter-plan communication with other BlueCross and BlueShield Plans as well as provider and member correspondence. In completing these activities, the Claims & Adjustments Specialist is responsible for ensuring performance levels meet or exceed established timeliness and accuracy benchmarks.& Adjustments Specialist is responsible for maintain inventories which focus on the accurate and timely processing of member claim as well as member and provider inquiries. The Claims & Adjustments Specialist will process fully insured group, fully insured non-group and self insured in-state and out-of-area claims for Mississippi members. The Claims & Adjustments Specialist is also responsible for handling member and provider inquiries and inter-plan communication with other BlueCross and BlueShield Plans as well as provider and member correspondence. In completing these activities, the Claims & Adjustments Specialist is responsible for ensuring performance levels meet or exceed established timeliness and accuracy benchmarks.
Job-Specific Requirements
- Bachelor's degree required.
- Must have average PC skills including experience with Microsoft Office suite
- Logical thought process in order to interpret and apply contract benefits as well as identify issues, recommend solutions, interpret and apply contract benefits and accurately adjust claims.
- Customer focused and service oriented to ensure timely and accurate performance and benchmark achievement.
- Ability to work with a high degree of accuracy and attention to detail to ensure work products are of high quality.
Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We offer a comprehensive benefits package that is worth approximately one-third of the salary compensation. Our benefits program is among the best in the health care field. We are looking for employees who can bring their experience, expertise and dedication to work for our customers.
