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Technical Information Specialist
BlueCross BlueShield of South Carolina. Maintain records and process claims in medical review .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates proficiency in claims processing and administrative support, with strong analytical and communication skills. Capable of maintaining accurate records and handling sensitive information while providing excellent customer service.
Highest-signal resume keywords
Claims ProcessingAdministrative SupportMicrosoft Office ProficiencyAnalytical SkillsCustomer Service Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims KnowledgeQuality ControlRecord MaintenanceTroubleshootingData Analysis
Soft Skills
Organizational SkillsVerbal CommunicationWritten CommunicationGood JudgmentDiscretion
Tools & Technologies
Word Processing SoftwareMicrosoft OfficeFISS
Industry Keywords
MedicareClaims DenialsAdjustment ClaimsMedical ReviewProvider Communication
About the role
Key responsibilities & impact- Maintain records and process claims in medical review
- Process ingoing and outgoing mail and prepare work for nursing staff
- Troubleshoot claims before and after nurse review
- Monitor claim-processing timeliness and adjust incorrectly keyed claims
- Perform quality control of work processes
- Process claim denials and adjustment claims for pre-pay and post-pay departments
- Investigate and analyze adjustment claim history and denial records
- Prescreen records for review and maintain accurate claim records
- Communicate with providers and assist the provider service department with inquiries
- Generate educational correspondence to providers regarding denials
- Assist the manager with special projects
- Serve as clerical support for Palmetto GBA's medical review team
Requirements
What you’ll need- Associate's degree, or 2 years of job-related work experience as degree equivalency
- 1 year of administrative/clerical support experience
- Working knowledge of word processing software
- Strong analytical, organizational, and customer service skills
- Strong verbal and written communication skills
- Proficiency in spelling, punctuation, and grammar
- Good judgment skills
- Ability to handle confidential or sensitive information with discretion
- Proficiency with Microsoft Office
- FISS experience preferred
- Medicare experience preferred
- Claims knowledge preferred
Benefits
Comp & perks- 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
- Supplemental pay until enrolled in health benefits 28 days after the hire date