Adv. Manufacturing

Summary We are currently hiring for a Claims Customer Service Advocate II to join BlueCross BlueShield of South Carolina. You will be responsible for responding to customer inquiries. Inquiries may be non-routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures. Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, 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 that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future. Description Position Purpose: This role is part of an inbound call center and directly helps our customers by responding to inquiries that may be non-routine and require deviation from standard screens, scripts and procedures. Research may be required to resolve these inquiries. Other responsibilities include review and adjudication of claims and/or non-medical appeals, determining whether to return, deny or pay claims while following policies and procedures. Location: This position is full-time (40 hours/week) Monday - Friday in a typical office environment. Employees are required to work a training and work schedule of 8:00am to 4:30. It may be necessary, given the business need to work occasional overtime and weekends. This role is located at 4101 Percival Road, Columbia SC. What You'll Do: You'll ensure effective customer relations by responding accurately, timely and courteously to our customers. These responses may be by telephone, written, web or walk-in inquiries. You will handle situations which may require a different set of responses or extensive research. Adhering to department guidelines, you will also identify claims that have been incorrectly processed and will enact process adjustments and reprocessing actions. You will examine and process claims and/or non-medical appeals while ensuring business/contract regulations, internal standards and examining guidelines. Another responsibility is to enter claims into the claim system after verifying correct coding of procedures and diagnosis codes. Claims must be processed according to established quality and production standards. You'll identify complaints and inquiries that may be complex and that cannot be resolved following usual procedures and guidelines and refer to a team lead or manager for resolution. You will also identify and report fraud and abuse situations. To Qualify for This Position, You'll Need: Required Education: High School Diploma or equivalent Required Work Experience: 2 years of customer service experience including 1 year claims or appeals processing OR Bachelor's Degree in lieu of work experience. Required Skills and Abilities : Good verbal and written communication skills. Strong customer service skills. Good spelling, punctuation and grammar skills. Basic business math proficiency. Ability to handle confidential or sensitive information with discretion. Required Software and Other Tools: Microsoft Office. Our Comprehensive Benefits Package Includes The Following 401(k) retirement savings plan with company match. Subsidized health plans and free vision coverage. Life insurance. Paid annual leave - the longer you work here, the more you earn. Nine paid holidays. On-site cafeterias and fitness centers in major locations. Wellness programs and a healthy lifestyle premium discount. Tuition assistance. Service recognition. 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 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. If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or 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 more information . Some states have required notifications. Here's more information .

Job Responsibilities Processes requisitions utilizing all procurement sourcing methods in compliance with the SC Consolidated Procurement Code, SC Regulations, and University departmental policies and procedures. Solicits, evaluates, and awards offerors for simple and complex purchases to include goods and services, professional services and construction related projects. Performs systemwide duties related to the procurement of complex construction projects for the University System. Collaborates with Design and Construction Project Managers and Office of the State Engineer when necessary and in accordance with State and University procurement related policies, rules, and regulations. Advertised Salary: $54,165 - Salary commensurate with qualifications Minimum and Additional Requirements Requires a bachelor’s degree in a job related field and 2 or more years of job related experience, which may be substituted by an equivalent combination of job related certification, training, education, and/or experience. Preferred Qualifications Universal Public Procurement Certification Council (UPPCC), CPPO or CPPB. NIGP-CPP is preferred. Additional Comments A knowledge of State and University policy and procedures. Familiarization with SC Consolidated Procurement Code and an interest in construction procurement. Knowledge of state procurement and/or professional services. Capable of working harmoniously with a diverse group of people. Must possess excellent written and oral communication skills. Good analytical and decision making skills. EEO Statement: The University of South Carolina does not discriminate in educational or employment opportunities or decisions for qualified persons on the basis of age, ancestry, citizenship status, color, disability, ethnicity, familial status, gender (including transgender), gender identity or expression, genetic information, HIV/AIDs status, military status, national origin, pregnancy (false pregnancy, termination of pregnancy, childbirth, recovery therefrom or related medical conditions, breastfeeding), race, religion (including religious dress and grooming practices), sex, sexual orientation, veteran status, or any other bases under federal, state, local law, or regulations.

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Develop & lead projects by applying 6 sigma principles to conduct process flow analysis, improve process time, create cycle time definitions, improve 1st pass…

Develop & lead projects by applying 6 sigma principles to conduct process flow analysis, improve process time, create cycle time definitions, improve 1st pass…

Develop & lead projects by applying 6 sigma principles to conduct process flow analysis, improve process time, create cycle time definitions, improve 1st pass…

Develop & lead projects by applying 6 sigma principles to conduct process flow analysis, improve process time, create cycle time definitions, improve 1st pass…

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Works to resolve daily and long-term problems/projects using manufacturing, quality, and Schneider Production System tools and lean manufacturing methodology.