Claims Customer Service Manager-Pharmacy & AccrueHealth - Internal Only

001 BlueCross and BlueShield of South Carolina - Columbia, SC

Full-time - Mid Level

Columbia, SC

About the position

This position is responsible for managing claims and customer service areas, ensuring excellent service delivery and timely processing of claims or appeals. The role involves overseeing staff, preparing management reports, and maintaining effective relationships with both internal and external customers.

Responsibilities

• Manages staff responsible for providing excellent customer service and timely and accurate processing of claims or appeals.
• Ensures department standards for production, timeliness, and quality are met.
• Prepares and reviews management reports.
• Monitors monthly reports to ensure department standards for production, timeliness, and quality are met.
• Makes recommendations for process improvements.
• Maintains effective relationships with internal and external customers by assisting with inquiries and resolving issues.

Requirements

• Bachelor's Degree or equivalent 4 years of job-related work experience, or an Associate's degree with 2 years of job-related work experience.
• 3 years of insurance experience in claims or appeals processing and customer service.
• 1 year of supervisory/team lead experience or equivalent military experience in grade E4 or above.
• Strong oral and written communication and organizational skills.
• Excellent customer service skills.
• Good judgment and ability to persuade, negotiate, or influence.
• Proficient in spelling, punctuation, and grammar.
• Proficient in Microsoft Office.

Nice-to-haves

• 5 years of insurance experience in claims processing and customer service.
• 2 years of supervisory/team lead experience or 2 years of equivalent military experience in grade E4 or above (may be concurrent).
• Demonstrated project management and presentation skills.
• Basic business math skills.
• Extensive knowledge of insurance law.
• Knowledge of medical management and membership systems.

Benefits

• 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