Description:
This position is onsite at our Percival Road location in Columbia, SC. Please be advised that during the interview process, you will need to provide a writing sample for review by the hiring manager.
What You’ll Do:
- Distributes daily work to employees, tracks workload and employee performance, and makes appropriate decisions necessary to ensure all processing expectations and team goals are met.
- Responds accurately and timely to inquiries from team members, including management, concerning customer inquiries, claims adjudication, appeals and other technical issues.
- Investigates and initiates resolutions to complex problems.
- Authorizes payment recovery, claim payments, or makes claim rejections based on documented information and provisions of state or federal law.
- Identifies issues with procedures and processes and provides feedback to management on changes and development.
- Trains new employees and introduces new material to all employees.
- Develops, updates, and maintains procedural manuals.
- Serves as liaison with other departments to address claim, system and quality issues.
- May perform some testing functions and attend/participate in meetings as needed.
To Qualify for This Position, You’ll Need:
- High School Diploma or equivalent
- 3 years of customer service experience and 1 year of claims or appeals processing experience OR Bachelor’s Degree in lieu of work experience.
- Excellent verbal and written communication skills.
- Strong customer service skills.
- Proficient spelling, punctuation, grammar, and basic business math.
- Ability to handle confidential or sensitive information with discretion.
- Knowledge of claims processing procedures.
- Experience with Microsoft Office.