Job Description

Job Description

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.

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 (Electronic Data Interchange)-related issues as required by business contracts.

Description

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 advices, 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.

Work Environment:

• Typical office environment.

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

Required Education:

• Associate's in a job-related field.

Degree Equivalency:

• An extra 2 years of job-related work experience for a total of 4 years required work experience. (see "required work experience")

Required Work Experience:

• 2 years of applicable EDI (Electronic Data Interchange) experience.

Required Skills and Abilities:

• Good system research and analysis skills.
• Working knowledge of relevant EDI (Electronic Data Interchange) 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:

• 2+ years of customer service experience.
• Call center experience.
• Familiarity with government contracts or previous/current work experience with Palmetto GBA or BCBSSC is also a plus.
• X12 claims data experience.

​ 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 access and opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

Our comprehensive benefits package includes:

• Subsidized health plans, dental and vision coverage
• 401K retirement savings plan with company match
• Life Insurance
• Paid Time Off (PTO)
• Nine paid holidays
• On-site cafeterias and fitness centers in major locations
• Wellness program and healthy lifestyle premium discount
• Tuition assistance
• Service recognition
• Employee Assistance
• Discounts to movies, theaters, zoos, theme parks and more

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. Management will be conducting interviews with those candidates who qualify with prioritization given to those candidates who demonstrate the preferred qualifications.

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.

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