BlueCross BlueShield of South Carolina
10,000+ employees
Founded 1946
⚕️ Healthcare Insurance
💸 Finance
Healthcare Insurance • Insurance • Finance
BlueCross BlueShield of South Carolina is a leading health insurance provider that offers a variety of health plans, including individual and family plans, Medicare options, and group health plans. The organization focuses on providing coverage and resources for members, employers, and healthcare providers, ensuring access to quality healthcare services. With a commitment to promoting healthier lifestyles and supporting community health, BlueCross BlueShield of South Carolina plays a vital role in the healthcare landscape of the region.
Senior Stoploss Claim Auditor
🕒 4 days ago
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BlueCross BlueShield of South Carolina
10,000+ employees
Founded 1946
⚕️ Healthcare Insurance
💸 Finance
Healthcare Insurance • Insurance • Finance
BlueCross BlueShield of South Carolina is a leading health insurance provider that offers a variety of health plans, including individual and family plans, Medicare options, and group health plans. The organization focuses on providing coverage and resources for members, employers, and healthcare providers, ensuring access to quality healthcare services. With a commitment to promoting healthier lifestyles and supporting community health, BlueCross BlueShield of South Carolina plays a vital role in the healthcare landscape of the region.
📋 Description
• Audit and authorize reimbursement of specific medical stop loss claims • Effectively mitigate client medical stop loss claims and provide excellent customer service • Analyze and adjudicate stop loss claims and request appropriate reimbursement from carrier • Communicate effectively with carriers, vendors, and management
🎯 Requirements
• Associate's degree • 6 years of managed care or reinsurance claims experience • Analyzes laws, regulations and contract language • Evaluates issues and develops recommendations • Handles confidential and sensitive information
🏖️ Benefits
• Health insurance • 401(k) matching • Paid time off • Flexible working arrangements • Professional development opportunities
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