Ourhrconnect

Ourhrconnect

Appeals Director

Columbia, South Carolina · Director · Contract

Sponsorship not specifiedDetected 6 days ago
Customer SupportCommunicationClaims Management

About the role

  • Summary Provides direction and guidance to appeals, customer service, and claims processing staff for multiple operational areas.
  • We strongly prefer experience in FISS, MAS, PECOS, and HIGLAS and management in a Medicare Administrative Contractor operational setting.
  • Description Location: This position is onsite full-time (40-hours/week) Monday-Friday in a typical office environment.

Responsibilities

  • 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.
  • 20% Works closely with areas to track performance and develop measures of success. Implements process improvements.
  • 10% 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.
  • 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.

Requirements

  • You may be required to travel between buildings.
  • 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.)
  • 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.
  • Required Skills and Abilities: Strong organizational, analytical, presentation, and customer service skills.
  • Required Software and Tools: Microsoft Office.

Skills

  • 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.
  • Microsoft Office.

Compensation

  • This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.

Benefits

  • Subsidized health plans, dental and vision coverage
  • 401k retirement savings plan with company match
  • Life Insurance
  • Paid Time Off (PTO)
  • Education Assistance
  • Required Education: Bachelor's
  • 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.

Company info

  • 10% 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.

Equal opportunity

  • 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 disabilities and 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.
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This listing is sourced directly from Ourhrconnect's careers page and normalized into a canonical job model.