EDI Operations Associate II - Palmetto GBA

Internal Reference Number: R1051060
Summary Palmetto GBA is one of the nation's largest providers of high-volume claims and transaction processing, contact center operations, and technical services to the federal government and other commercial customers. Our core business is providing services to CMS Medicare beneficiaries, providers, and health plans. Palmetto GBA is one of the few Medicare contractors with experience in all Medicare business segments - Medicare Part A, Medicare Part B, Durable Medical Equipment (DME), Home Health and Hospice (HHH), and Medicare Advantage (MA) Part C and Part D. This broad experience base offers CMS a contractor with unique expertise and the ability to offer customized, creative, and proven solutions to complex problems.Description

Position Purpose:

Provides first and second level technical support to a variety of customers comprising the submitter community, as well as basic internal support via analysis and research into EDI-related issues as required by business contracts.

Location:

This position is full-time (40 hours per week, Monday-Friday) and fully onsite in a typical office environment located in Columbia, SC.

Logistics:

This position is with Palmetto GBA - one of BlueCross BlueShield's South Carolina subsidiary companies.

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

What You'll Do :

• Provides quality/timely internal/external customer technical support/service for variety of insurance contracts as assigned. This encompasses, but is not limited to, support of communication interfaces/transactions/functions as required by insurance laws (such as support of claims, remit advice, inquiry/response for claims status/eligibility, enrollment, premium payment etc.), support of all current formats/transactions required by law/BCBSSC lines of business.
• Responsible for the setup of all electronic transactions submission by processing enrollment applications, updating associated system files, and managing customer notification.

To Qualify for This Position, You'll Need the Following :

Required Education:

• Associate's in a job related field.

Degree Equivalency:

• 4 total years required work experience.

Required Work Experience:

• 2 years of applicable EDI experience.

Required Skills and Abilities:

• Good system research and analysis skills.
• Working knowledge of relevant EDI software and tools used by the company/contract.
• Good organizational, judgment, customer service, and both verbal and written communication skills.
• Good spelling, punctuation, and grammar skills.
• Basic math and computer skills.
• Ability to handle confidential or sensitive information with discretion.

Required Software and Other Tools:

• Microsoft Office.

We Prefer That You Have the Following :

• Experience working on MAC Contracts.
• Experience handling remits on GP Claims and Front-end rejections.
• Medicare experience.
• Experience with EDI enrollments pertaining to Medicare
• 3 years-of applicable EDI experience.

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.

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.

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 View email address on click.appcast.io call View phone number on click.appcast.io 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.

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