Join us and be part of the National Alliance team that provides world-class service for health plan members nationwide. A division of BlueCross BlueShield of South Carolina, National Alliance builds partnerships with other blue plans across the United States to offer health plan administration for self-funded accounts. Learn more at nationalalliance.com.
Logistics:
This position onsite at our Percival Road location in Columbia, SC. During training the work hours will be 8am-4:30pm. After training, candidates must be available to work a shift between the hours of 8:00am and 8:00pm.
What You’ll Do:
- Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, or walk-in inquiries.
- Handles situations which may require adaptation of response or extensive research.
- Identifies incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines.
- Examines and processes claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines.
- Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes.
- Ensures claims are processing according to established quality and production standards.
- Identifies complaints and inquiries of a complex level that cannot be resolved following desk procedures and guidelines and refers these to a lead or manager for resolution.
- Identifies and reports potential fraud and abuse situations.
To Qualify for This Position, You’ll Need:
- High School Diploma or equivalent
- 2 years of customer service experience including 1 year claims or appeals processing OR Bachelor's Degree in lieu of work experience.
- Good verbal and written communication skills.
- Strong customer service skills.
- Good spelling, punctuation and grammar skills.
- Basic business math proficiency.
- Ability to handle confidential or sensitive information with discretion.
- Experience with Microsoft Office.
Job Type: Full-time
Pay: Up to $17.25 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) 6% Match
- 401(k) matching
- Dental insurance
- Employee assistance program
- Employee discount
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- On-site gym
- Paid time off
- Prescription drug insurance
- Professional development assistance
- Tuition reimbursement
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work setting:
Experience:
- Claims Processing: 2 years (Preferred)
Work Location: In person