Claims Operations Manager

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. You will work an 8-hour shift scheduled during our normal business hours of 8:30AM-5:30PM . This role is located at 2743 Perimeter Parkway, Augusta, GA 30909. 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 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: 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 Required Skills and Abilities: Analyzes claims deferrals Diagnoses claims issues Enters claims data Reviews work from others Uses sound reasoning when processing claims We Prefer That You Have The Following: Preferred Software and Other 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 We Can Do for You: We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company. #J-18808-Ljbffr