Technical Support Manager - CGS

Bluecross Blueshield Of South Carolina Nashville , TN 37201

Posted 2 months ago

Summary

Manages the technical support associates who support the claims standard processing system. Ensures the system is processing correctly; file maintenance including use of if then logic, testing of other components, problem research, security administration and also pricing. Contributes to achieving the goals for security and innovation.

Description

  • 25% Directs and manages system file maintenance activities.
  • 25% Manages and directs applications testing including all electronic data interchange format testing and evaluation of test results. Oversees the development and verification of test data and detailed user acceptance plans.
  • 15% Oversees joint communications and acts as liaison between groups. Ensures appropriate communication of detailed technical information between users and the shared system maintainer.
  • 15% Directs and manages the loading of pricing files to ensure they are correct/current and that claims pay appropriately. Directs and manages the analyzing of releases to determine the effects on processes and other applications.
  • 10% Monitors projects, resources and costs for enhancements and programming change requests and oversees issues related to business process improvements.
  • 5% Manages and directs the monitoring and administration of system identifications and accesses for the area. Performs audits of accesses to the area system (s) and applications to ensure the segregation of duty principles in respect to direct reports.
  • 5% Leads associates in accordance with corporate policies and support of quality standards.

Required Education:

  • Bachelor's degree in Information Technology, Business, Computer Science, or other job-related field

Required Work Experience:

  • Eight years of experience to include six years of job-related information systems experience and either two years of supervisory experience OR two years of equivalent military experience in grade E4 of above

Preferred Work Experience:

  • MCS/Medicare Part B claims processing standard system knowledge and experience

Required Skills and Abilities:

  • Demonstrated organizational and leadership skills in a team environment

  • Excellent oral and written communication skills

  • Attention to detail

  • Good analytical and decision-making skills

Required Software and Tools:

  • Microsoft Office to include strong proficiency with Word and Excel

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

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 abilities@bcbssc.com or call 1-800-288-2227, ext. 43172 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Qualified Independent Contractor Analyst CGS Administrators

Bluecross Blueshield Of South Carolina

Posted 1 week ago

VIEW JOBS 1/15/2022 12:00:00 AM 2022-04-15T00:00 Summary Maintains files on the systems for research and problem resolution during the Medicare appeals process. Ensures timeliness standards are met by ensuring accuracy of information for effectuating claims decisions and payments. Description * Follows adjustments that have been reversed through edits in the system until either completed for payment or determination is made that intervention is necessary. Resolves all problems related to the adjustment. * Maintains pending reports related to effectuated cases assigned, ensuring timeliness of their completion and accurately maintaining the inventory and decision effectuation information. * Functions as team leader by completing data preparation for projected overpayments, monitoring daily work schedules, resolving workflow issues, and monitoring claims payment for correct effectuation. * Acknowledges receipt of all case file decisions within defined timeframe. * Researches and resolves inquiries from customer service, providers, hearing officers and other support areas. Required Education: * Bachelor's Degree or 4 years of job related work experience (claims processing/adjusting). Required Work Experience: * Two years Medicare or hearings experience or equivalent office claims experience. Required Skills and Abilities: * Strong interpersonal, communication skills. Ability to work independently without direct supervision as well as in a team environment. Knowledgeable in hearings or claims request research and inquiries. Required Software and Tools: * Microsoft Office. Preferred Education: * Bachelor's degree- any major Preferred Specialized Training: * 12 hours of project management; advanced training in medical terminology and Healthcare Common Procedure Coding System (HCPCS) coding. Preferred Work Experience: * Three Medicare claims or equivalent office experience. Preferred Skills and Abilities: * Advanced knowledge of computer systems, spreadsheets, and working with databases. Advanced knowledge of Medicare systems, MCS, MMD, MDC, HIMR, and FSS. Work Environment: * Typical office environment. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. 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 abilities@bcbssc.com or call 1-800-288-2227, ext. 43172 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. Bluecross Blueshield Of South Carolina Nashville TN

Technical Support Manager - CGS

Bluecross Blueshield Of South Carolina