<p>Summary</p> <p>Responsible for ensuring the prompt, appropriate and accurate distribution of case files and maintaining statistics on questionnaires, ROC06 claims and caseloads.</p> <p>Description</p> <p>Location:</p> <p>This position is full-time (40 hours/week) Monday-Friday in a typical office environment. Employees are required to have flexibility work any our 8-hour shift scheduled during hours of 8:00 AM -5:00 PM. Training will be Monday - Friday 8:00 AM - 4:30/5:00 PM for 6-8 weeks. This role is located on site at 4101 Percival Road, Columbia SC</p> <p>What You'll Do:</p> <ul> <li>Research positive questionnaires, activate RCN numbers and assign cases to claims adjusters accordingly. </li><li>Maintain statistics and prepare monthly reports concerning questionnaires, ROC06 claims, positive/negative questionnaire responses, assignment of cases, types of cases, and undelivered mail. </li><li>Open ITS ROC6 claims. </li><li>Prepare monthly and quarterly savings reports for cost containment and ASO accounts. Prepare monthly reports concerning assignment of cases and the quantity of work performed by adjusters. </li><li>Open non-ITS ROC06 claims. </li><li>Respond to accident reports from nursing department. </li></ul> <p>To Qualify for This Position, You'll Need the Following:</p> <ul> <li>Required Education: </li><li>Associate's </li><li>Degree Equivalency: </li><li>2 years of job-related work experience. </li><li>Required Work Experience: </li><li>1 year of experience in claims or customer service </li><li>Required Skills and Abilities: </li><li>Analyzes laws, regulations and contract language </li><li>Evaluates issues and develops recommendations </li><li>Handles confidential and sensitive information </li><li>Investigates assigned claims </li><li>Proposes claims adjustments and refunds </li><li>Works claims caseloads </li></ul> <p>Our Comprehensive Benefits Package Includes the Following:</p> <p>We offer our employees great benefits and rewards. You will be eligible to participate in the benefits for the first of the month following 28 days of employment.</p> <ul> <li>Subsidized health plans, dental and vision coverage </li><li>401K retirement savings plan with company match </li><li>Life Insurance </li><li>Paid Time Off (PTO) </li><li>On-site cafeterias and fitness centers in major locations </li><li>Wellness program and healthy lifestyle premium discount </li><li>Tuition assistance </li><li>Service recognition </li><li>Employee Assistance </li><li>Discounts to movies, theaters, zoos, theme parks and more </li></ul> <p>What We Can Do for You:</p> <p>We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.</p> <p>What to Expect Next:</p> <p>After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.</p> <p>Management will conduct interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the required qualifications.</p> <p>Equal Employment Opportunity Statement</p> <p>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 individuals with disabilities and protected 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.</p> <p>We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.</p> <p>If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.</p> <p>We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information.</p> <p>Some states have required notifications. Here's more information.</p>