Claims and Appeals Specialist

1 week ago


Myrtle Beach, South Carolina, United States BlueCross BlueShield of South Carolina Full time

Job Title: Claims and Appeals Specialist

About the Role

We are seeking a highly skilled Claims and Appeals Specialist to join our team at BlueCross BlueShield of South Carolina. As a Claims and Appeals Specialist, you will play a critical role in ensuring the accuracy and efficiency of our claims processing operations.

Key Responsibilities

  • Claims Processing: Process claims and appeals in accordance with company policies and regulatory requirements.
  • Customer Service: Respond to customer inquiries and provide timely and accurate information regarding claims status.
  • Fraud Detection: Identify and report potential fraudulent activities to ensure the integrity of our claims processing operations.

Requirements

  • Education: High School Diploma or equivalent required; Bachelor's Degree preferred.
  • Experience: One year of experience in a related field or equivalent combination of education and experience.
  • Skills: Strong communication and customer service skills; proficiency in Microsoft Office.

Preferred Qualifications

  • TRICARE Experience: Previous experience working with TRICARE customers or claims processing.

Benefits

  • Retirement Plan: 401(k) retirement savings plan with company match.
  • Health Insurance: Subsidized health plans and free vision coverage.
  • Life Insurance: Company-provided life insurance.
  • Time Off: Paid annual leave and holidays.
  • On-Site Amenities: On-site cafeterias and fitness centers.
  • Professional Development: Wellness programs and tuition assistance.
  • Recognition: Service recognition program.

Application Process

Qualified candidates will be contacted for an interview. We are an equal opportunity employer.



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