Manager, Claims Operations

What You'll Do:

• Monitors and evaluates one or more units to ensure the accurate and timely processing of claims. Develops effective claims processing standards that incorporate the use of automated claims systems and other technology solutions.
• Ensures compliance with all applicable laws, regulations, and contract requirements while meeting performance expectations.
• Monitors all reports and quality audits to ensure the efficient operation of the department. Ensures proper training for new and current staff.
• Maintains a high level of customer service with all internal and external customers. Interacts regularly with internal departments for planning, training, and management purposes.

To Qualify for This Position, You'll Need:

• Bachelor's degree.
• 4 years job related work experience or Associate's and 2 years job related work experience (Equivalency not applicable for the Celerian Group. Bachelor's degree required.).
• 4 years of claims processing experience, including either 2 years of lead or supervisory experience OR 2 years of equivalent military experience in grade E4 or above.
• Ability Analyzes claims deferrals, diagnoses claim issues, enters claims data, and reviews work from others.
• Ability to uses sound reasoning when processing claims.

What Blue Can Do for You:

We understand the value of a diverse and inclusive workplace. We strive to be an employer across all spectrums where employees can develop their skills, advance their careers, and contribute their unique abilities to the growth of our company.

Our comprehensive benefits package includes:

• Subsidized health plans, dental and vision coverage
• 401K retirement savings plan with company match
• Life Insurance
• Paid Time Off (PTO)
• On-site cafeterias and fitness centers in major locations
• Wellness program and healthy lifestyle premium discount
• Tuition assistance
• Service recognition
• Employee Assistance
• 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 you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.

Management will be conducting interviews with those candidates who qualify, with prioritization given 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.

Some states have required notifications. Here's more information.

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 mycareer.help@bcbssc.comor call 1-800-288-2227, ext. 47480 with the nature of your request. We will decide regarding your request for reasonable accommodation on a case-by-case basis.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

Some states have required notifications. Here's more information.

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 mycareer.help@bcbssc.com or call 1-800-288-2227, 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.