Job description
Summary
Position Purpose:
In the role as an Investigation Clerk, the ideal candidate will ensure claims can be processed timely to meet departmental goals by reviewing claims for proper information as well as returning claims or requesting missing information.
Description
Investigation Clerk
Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation’s 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 that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!
Logistics:
This position is full-time position (40 hours per week) Monday through Friday 6:00am-2:30 pm onsite to 4101 Percival Road, Columbia, SC 29219.
What You’ll Do:
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Investigate claims in order to provide information that is missing or cannot be determined by processors
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Contact providers and members to obtain information necessary to process claims
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Screen, code, count, and sort batches and logs all work to be distributed to staff
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Ensures prompt and efficient distribution of work
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Research provider numbers on the claims system to ensure accurate processing
To Qualify for This Position, You’ll Need:
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A high school diploma or equivalent
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Communicates appeals status
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Documents appeals resolution
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Processes appeals
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Supports second level reviews
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Works claims caseloads
What We can Do for You:
We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.
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Subsidized health plans, dental and vision coverage
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401K retirement savings plan with company match
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Life Insurance
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Paid Time Off (PTO)
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On-site cafeterias and fitness centers in major locations
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Wellness program and healthy lifestyle premium discount
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Tuition assistance
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Service recognition
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Employee Assistance
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Discounts to movies, theaters, zoos, theme parks and more
What to Expect Next:
After submitting your application, our recruiting team members will review your resume to ensure your meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. If the qualifications required proof of semester hours, please attach your transcript to your application.
Management will be conducting interviews with the most qualified candidates, with prioritization give to those candidates who demonstrate the preferred qualifications.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains Affirmative Action programs to promote employment opportunities for minorities, females, disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.
We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities.
If you need special assistance or an accommodation while seeking employment, please e-mail abilities@bcbssc.com or call 1-800-288-2227, ext. 43172 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
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