Stop Loss Coordinator

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!

Position Purpose:

Provides reinsurance support for new and renewal business, underwriting, claims audit/record keeping and/or other functions. May perform calculations and process general accounting requests for billing or payments, and/or check the status of claims and process policy changes. Provides customer service to clients and partners. Runs reports as needed.

Logistics:

iiSi | Writing Medical Stop Loss Across the Nation - one of BlueCross BlueShield of South Carolina's subsidiary companies.

Location:

This position is full-time (40-hours/week) Monday-Friday in a typical office environment located at 10199 Southside Blvd, Suite 205, Jacksonville, FL 32256.

Sponsorship:

This position is not eligible for sponsorship now or in the future.

What You'll Do:

• Processes mail, email and faxes to maintain departmental productivity, quality and timeliness standards. May assist in preparing various financial data associated with refunds, recoupments, adjustments, and reissues, and ensure appropriate documentation for each refund request and associated payment. Maintains logs. Assists in processing/providing routine premium billing statements and/or various reports. Maintains filing systems.
• Coordinates communication of information between reinsurance companies and various internal and external areas. Reviews documentation for completeness, and may rate new business, order required reports within timeliness standards, determine benefits, issue new policies, and/or report surplus lines taxes. Requests additional information when needed within timeline standards. Accurately documents process changes.
• Checks status of claims or notices and may service existing accounts by processing endorsements/amendments, identifying problems, and responding to inquiries. May review disbursement requests for large case management claims and other specific diagnosis codes, and forward to claims for detailed review.
• Ensures effective customer relations by responding accurately, timely, and courteously to telephone or written customer inquiries. Accurately documents inquiries.

To Qualify For This Position, You'll Need The Following:

• Required Education: High School Diploma or equivalent.
• Required Experience: 1 year customer service or administrative experience.
• Required Skills and Abilities: Excellent verbal and written communication skills. Good human relations skills. Strong research ability. Ability to function in a high-pressure environment with minimum supervision. Ability to handle confidential or sensitive information with discretion. Strong organizational skills. Proven customer service skills. Good judgment. Proficient spelling, punctuation, grammar, and basic math skills.
• Required Software and Tools: Microsoft Office.

We Prefer That You Have The Following:

• Preferred Education: Associate Degree-Business Administration or related field
• Preferred Work Experience: 2 years-customer service, operations support, underwriting experience, or claims experience.
• Skills and Abilities: Intermediate Excel skills

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 individuals with disabilitiesand protected 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 disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.comor call 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.

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

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