BlueCross BlueShield of South Carolina

Director, Claims Customer Service

Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree required; equivalent experience may apply for some roles.
  • 7 years of healthcare program or customer service experience, including budget management.
  • 3 years of management or supervisory experience required, or equivalent military experience at E4 or higher.
  • Strong organizational, analytical, and communication skills necessary for the role.
  • Proficiency in Microsoft Office is essential.

Responsibilities

  • Direct customer service, claims processing, and appeals operations for prompt and accurate service.
  • Develop and support strategic initiatives to enhance provider and customer satisfaction.
  • Track performance metrics and implement process improvements across various functions.
  • Lead projects addressing system limitations and enhancements.
  • Manage departmental budget and staffing to support operational goals.
  • Provide excellent customer service to employees, customers, and management.

Benefits

  • Subsidized health, dental, and vision insurance options.
  • 401k plan with company match to support retirement savings.
  • Life insurance coverage for added security.
  • Generous Paid Time Off (PTO) policy.
  • Access to on-site cafeterias and fitness centers in major locations.
  • Education assistance program for ongoing learning.
  • Recognition for long service with the company.
  • National discounts on entertainment options like theaters and theme parks.
Full Job Description
Summary
Provides direction and guidance to customer service, claims processing, and/or appeals staff for multiple operational areas.
Description

Logistics: Palmetto GBA - one of BlueCross BlueShield's South Carolina subsidiary companies.

Location: This position is full-time (40-hours/week) Monday-Friday in a typical office environment. This role is located at 2743 Perimeter Parkway, Augusta, GA 30909.

Position Purpose:

The Director of Claims Customer Service leads customer service, claims processing, and appeals operations to ensure timely, accurate service while driving initiatives that improve provider and customer satisfaction. This role oversees performance management, process improvements, system enhancements, and team development while supporting strategic goals and ensuring effective resource and budget management.

What You'll Do:
  • Directs customer service, claims processing, and/or appeals staff in ensuring prompt and accurate processing of items and inquiries. Develops and supports strategic initiatives to enhance provider and customer satisfaction.
  • Works closely with areas to track performance and develop measures of success. Implements process improvements.
  • Identifies system limitations and serves as project leader on system enhancements and updates.
  • Leads and supports achievement of departmental, divisional, and corporate strategic objectives. Collaborates with other functional areas to resolve multi-functional issues. Provides necessary assistance and resources when necessary.
  • Develops and monitors budget and resources for all assigned areas. Responsible for the selection, training, and development of staff. Ensures excellent customer service is given to employees, customers, management, etc.


To Qualify For This Position, You'll Need The Following:
  • Required Education: Bachelor's
  • Degree Equivalency: 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.)
  • Required Work Experience: 7 years of healthcare program or customer service experience to include budget management experience including 3 years of management/supervisory experience OR 3 years of equivalent military experience in grade E4 or above (may be concurrent).
  • Required Skills and Abilities: Strong organizational, analytical, presentation, and customer service skills. Strong oral and written communication skills. Ability to persuade, negotiate or influence. Ability to handle confidential or sensitive information with discretion. Proficient spelling, punctuation, grammar, and basic business math.
  • Required Software and Tools: Microsoft Office.


Our Comprehensive Benefits Package Includes The Following:

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.
  • 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
  • Education Assistance
  • Service Recognition
  • National 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.

About BlueCross BlueShield of South Carolina

BlueCross BlueShield of South Carolina is a health insurance company that provides coverage to over 5 million people in South Carolina and beyond. The company was founded in 1946 and is headquartered in Columbia, South Carolina. BlueCross BlueShield of South Carolina offers a variety of health insurance plans, including individual and family plans, Medicare plans, and employer-sponsored plans. The company is committed to improving the health of its members and the communities it serves, with initiatives focused on wellness, disease prevention, and access to care. BlueCross BlueShield of South Carolina is a subsidiary of the Blue Cross Blue Shield Association, a national federation of 36 independent, community-based and locally operated Blue Cross Blue Shield companies.
Learn more about BlueCross BlueShield of South Carolina
Size
12,000 employees
Industry

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