SA IV - Clinical Support
- Call center position supporting BCBSF's Pre Service Medical Review Team with written workload or callback assignments.
- Assist providers with the entry and update of requests for medical clearances
- Research, coordinate and resolve inquiries and claims exceptions
- Coordinate with other Provider Service areas to identify formal education opportunities
- Identify, document and monitor process improvements
- Moderate to heavy keying required.
- High School diploma or equivalent
- 2+ years experience in health insurance, provider's office (handling medical coding, filing insurance claims or referrals) or a managed healthcare experience
- Experience working with healthcare products including researching and resolving provider inquiries and working with provider contracts and networks
- Experience working with medical terminology, CPT-4 coding, ICD-9 coding and claims adjudication inquiry resolution processes and procedures
- Experience working with MS Word and Excel
- Experience with Legacy systems
- Successful performance on job related assessments
- May require 9:45 a.m. to 6:15 p.m. shift coverage
Job Status: Full Time