Claims Processor I – PGBA-21

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Job Details
Full-timeEstimated: $25,000 – $32,000 a year1 hour ago
Benefits
  • Health insurance
  • 401(k) matching
  • Tuition reimbursement
  • 401(k)
  • Vision insurance
Qualifications
  • Word processing
  • Analysis skills
  • Customer service
  • Communication skills
  • Microsoft Word
  • High school diploma or GED
Full Job Description
Summary

Responsible for the accurate and timely processing of claims.

Logistics

This position is on-site full-time Monday-Friday in a typical office environment. Employees are required to work from 8:00 AM to 5:00 PM. It may be necessary, given the business need to work occasional overtime and weekends. This role is located in Florence, SC.

Description

What You’ll Do

Research and process claims according to business regulations, internal standards, and processing guidelines. Verifies the coding of procedure and diagnosis codes.

Resolve system edits, audits, and claims errors through research and the use of approved references and investigative sources.

Coordinates with internal departments to work on edits and deferrals, updating the patient identification, other health insurance, provider identification, and other files as necessary.

To Qualify for This Position, You’ll Need

High School Diploma or equivalent.

Strong analytical, organizational, and customer service skills.

Strong oral and written communication skills.

Proficient spelling, punctuation, and grammar skills.

Good judgment skills.

Basic business math skills.

Basic office equipment.

We Prefer That You Have

1 year of experience in a healthcare or insurance environment.

Ability to use complex mathematical calculations.

Proficient in word processing and spreadsheet applications.

Proficient in database software.

What We Can Do For You:
Our comprehensive benefits package includes:
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 a healthy lifestyle premium discount

Tuition assistance

Service Recognition

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 conduct interviews with the most qualified candidates, and prioritization is given to those candidates who demonstrate the preferred qualifications.

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.

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