Job Responsibilities
- Routing claim issues to next level or appropriate support areas; following up to ensure completion.
- Inputting, reviewing and validating the claims data received; evaluating their reliability and effectiveness in line with coverage and appraisal.
- Assisting in routine claim analysis and final determination; delivering administrative support throughout all claim handling processes.
- Performing basic investigator tasks; gathering and documenting relevant information as a preliminary investigation.
- Must be able to pass required testing.
- Work overtime as required.
Job Qualifications
Education
- High School Diploma or equivalent
Skills\Certifications
- Proficient in Microsoft Office (Outlook, Word, Excel and Powerpoint)
- Proficient oral and written communication skills
- Proficient interpersonal and organizational skills
- Exceptional time management skills
- Independent, Sound decision-making and problem-solving skills
- If current employee with the company, must meet minimum performance expectations
PIO is seeking detail-oriented, self-motivated individuals with strong analytical skills to join our Home Claims department as a Claims Trainee. Proficiency in basic computer skills and good communication are essential. The ideal candidates are dedicated and quality-focused while working independently. The Claims Trainee will make all benefit, eligibility, and medical policy decisions as well as determine all prior authorization requirements. If you’re eager to learn and grow in the insurance industry, we want you on our team!
- Start date is 3-17-25.
- During training, hours are 8:00 AM – 4:30 PM EST Monday-Friday with a 30 minute lunch.
- After training, employees work a flex schedule between 6:00 AM and 6:00 PM EST Monday-Friday. (Additional flex opportunities may be available based on system availability.)
Number of Openings Available:
8
Worker Type:
Employee
Company:
Applying for this job indicates your acknowledgement and understanding of the following statements:
BCBST is an Equal Opportunity employer (EEO), and all employees and applicants will be entitled to equal employment opportunities when employment decisions are made. BCBST will take affirmative action to recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.
Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:
BCBST's EEO Policies/Notices
BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.
Tobacco-Free Hiring Statement
To further our mission of peace of mind through better health, effective 2017, BlueCross BlueShield of Tennessee and its subsidiaries no longer hire individuals who use tobacco or nicotine products (including but not limited to cigarettes, cigars, pipe tobacco, snuff, chewing tobacco, gum, patch, lozenges and electronic or smokeless cigarettes) in any form in Tennessee and where state law permits. A tobacco or nicotine free hiring practice is part of an effort to combat serious diseases, as well as to promote health and wellness for our employees and our community. All offers of employment will be contingent upon passing a background check which includes an illegal drug and tobacco/nicotine test. An individual whose post offer screening result is positive for illegal drugs or tobacco/nicotine and/or whose background check is verified to be unsatisfactory, will be disqualified from employment, the job offer will be withdrawn, and they may be disqualified from applying for employment for six (6) months from the date of the post offer screening results.
Resources to help individuals discontinue the use of tobacco/nicotine products include smokefree.gov or 1-800-QUIT-NOW.