Auditing/Stop Loss Technician (W@H South Carolina)

BlueCross BlueShield of South Carolina
life insurance, paid holidays, tuition assistance, 401(k), remote work
United States, South Carolina, Charleston
Feb 18, 2025
Summary We are currently hiring for an Auditing/Stop Loss Technician to join BlueCross BlueShield of South Carolina. In this role as an Auditing/Stop Loss Technician, you will be responsible for submitting stop-loss claims to our reinsurance carriers. Coordinates with claims and membership to obtain required supporting documentation for stop-loss reimbursements. Maintains/provides status updates via reporting, logs, and the stop-loss database of all outstanding submissions. Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and ann innovative future. Description Logistics This position is full-time (40 hours/week) Monday-Frriday from 8:30 am - 5:00 pm and will be Work from Home with mandatory on-site training in Columbia, SC at our Government Programs Complex for approximately 2-3 weeks. Candidates may have to come on-site occasionally for business needs. What You Will Do: Monitors aggregate and specific claims experience by use of specific analysis, loss ratio reporting, stop loss database and spreadsheets. Ensures prompt identification and accurate submission for stop loss recovery filings. Receives and processes stop loss reimbursements prior to forwarding to the client. Corresponds with the stop loss carrier to identify, analyze, and resolve any pending issues regarding outstanding stop loss submissions. Maintains and provides status updates by use of reporting, logs, and the stop loss database of all outstanding submissions. To Qualify For This Position, You Will Need: Associate's degree OR 2 years job-related work experience 3 years of membership/billing/accounts and/or audit/compliance experience. Knowledge of membership/billing/claims systems. Good judgment skills. Effective customer service and organizational skills. Demonstrated proficiency in spelling, punctuation, and grammar. Basic business math proficiency. Ability to persuade, negotiate, or influence others. Analytical or critical thinking skills. Ability to handle confidential or sensitive information with discretion. Microsoft Office. What We Prefer: Strong ability to multi-task and be detail-oriented Associate Degree in Accounting or Finance. Knowledge of code manuals and underwriting rules/regulations. Working knowledge of Microsoft Access or other database software. What We Can Do for You: 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 healthy lifestyle premium discount. Tuition assistance. Service recognition. Incentive Plan. Merit Plan. Continuing education funds for additional certifications and certification renewal. 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 a recruiter to verify resume specifics and salary requirements. Management will be conducting interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Some states have required notifications. Here's more information. 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 minorities, females, disabled individuals and 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 physical and mental disabilities. If you need special assistance or an accommodation while seeking employment, please e-mail mycareer.help@bcbssc.com or call 1-800-288-2227, 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.