Current jobs related to Claims Processor - Columbia - Kelly

  • Claims Processor II

    18 hours ago

    Columbia, South Carolina, United States Spectraforce Technologies Full time

    Job Title: Claims Processor IIWe are seeking a highly skilled Claims Processor II to join our team at Spectraforce Technologies. As a Claims Processor II, you will be responsible for reviewing and adjudicating complex or specialty claims, determining whether to return, deny or pay claims following organizational policies and procedures.Key...

  • Claims Processor

    2 weeks ago

    Columbia, South Carolina, United States Highmark Health Full time

    Job SummaryThis role is responsible for reviewing, evaluating, and processing claims to ensure accuracy and compliance with organizational policies and procedures. The successful candidate will have strong analytical and problem-solving skills, with the ability to work independently and as part of a team.Key ResponsibilitiesReceive and process claims,...

  • Insurance Claims Examiner

    4 days ago

    Columbia, South Carolina, United States BlueCross BlueShield of South Carolina Full time

    Claims Processor I Job DescriptionAs a Claims Processor I, you will be responsible for the accurate and timely processing of claims. This role is ideal for individuals who are detail-oriented and have excellent analytical skills.Key Responsibilities:Process claims in a timely and accurate mannerReview and analyze claims data to ensure accuracy and...

  • Processor, Claims II

    2 weeks ago

    Columbia, United States WillHire Remote Work Freelance Full time

    Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. Business and political climates may change, but we’re stronger than ever. Our A.M. Best rating is A+...

  • Insurance Claims Examiner

    2 weeks ago

    Columbia, South Carolina, United States BlueCross BlueShield of South Carolina Full time

    About the RoleAs a Claims Processor I at BlueCross BlueShield of South Carolina, you will be responsible for the accurate and timely processing of claims. This involves reviewing and analyzing claims data to ensure compliance with company policies and regulatory requirements.Why Work with Us?At BlueCross BlueShield of South Carolina, we value our employees...

  • Program Coordinator II

    14 hours ago

    Columbia, United States KG Workforce Solutions, LLC Full time

    Program Coordinator / Claims AnalystNormal Work Schedule: Monday - Friday (8:30 a.m. ET - 5:00 p.m. ET)Location: Columbia, SC (downtown); Onsite RequiredThere are a lot of jobs available right now. How do you know if this one might be right for you? We’ve compiled a few questions to help you make that decision!Are you looking for a career, not just a...

  • Program Coordinator II

    19 hours ago

    Columbia, United States KG Workforce Solutions, LLC Full time

    Program Coordinator / Claims AnalystNormal Work Schedule: Monday - Friday (8:30 a.m. ET - 5:00 p.m. ET)Location: Columbia, SC (downtown); Onsite RequiredThere are a lot of jobs available right now. How do you know if this one might be right for you? We’ve compiled a few questions to help you make that decision!Are you looking for a career, not just a...

  • Feed Procurement Specialist

    3 weeks ago

    New Columbia, Pennsylvania, United States Country View Family Farms Full time

    Job DescriptionAs a key member of the Country View Family Farms team, the Feed Procurement Specialist will play a vital role in supporting our feed milling operations across PA, IN, and NC. Reporting directly to the Procurement Director, this individual will take a hands-on leadership approach, overseeing grain and ingredient purchasing, transportation...

  • Ingredient Commodity Merchant

    1 month ago

    New Columbia, United States Country View Family Farms Full time

    As the Ingredient Commodity Merchant, you will play a key role in supporting our feed milling operations across PA, IN, and NC. Reporting directly to the Procurement Director, you will take a hands-on leadership approach, overseeing grain and ingredient purchasing, transportation logistics, quality assurance, and purchasing data management. Your leadership...

Claims Processor

4 months ago

Columbia, United States Kelly Full time
Job Summary:
We are seeking a motivated and detail-oriented Customer Service Representative to join our team. As a Customer Service Representative, you will be responsible for responding to customer inquiries, reviewing and adjudicating claims and appeals, and ensuring effective customer relations. This position requires strong communication skills, attention to detail, and the ability to handle confidential information with discretion. Join our team and contribute to providing excellent customer service in the healthcare industry.

Job Specifications:
- Job Type: Temp-to-hire
- Company: Kelly® Professional & Industrial
- Location: Columbia, SC
- Pay Rate: $15.00+ per hour
- Shift: between 8:00am - 8pm, Monday-Friday (40 hours per week)

Roles and Responsibilities:
- Respond accurately, timely, and courteously to telephone, written, web, or walk-in inquiries from customers
- Perform research as needed to resolve non-routine inquiries
- Review and adjudicate claims and non-medical appeals following organizational policies and procedures
- Determine whether to return, deny, or pay claims
- Identify incorrectly processed claims and process adjustments and reprocessing actions
- Examine and process claims and non-medical appeals according to business/contract regulations and internal standards
- Enter claims into the claim system after verifying correct coding of procedures and diagnosis codes
- Ensure claims are processing according to established quality and production standards
- Identify and report potential fraud and abuse situations
- Refer complex complaints and inquiries to a lead or manager for resolution

Qualifications & Skills:
- High School Diploma or equivalent required
- 2 years of customer service experience including 1 year of claims or appeals processing OR Bachelor's Degree in lieu of work experience
- Good verbal and written communication skills
- Strong customer service skills
- Good spelling, punctuation, and grammar skills
- Basic business math proficiency
- Ability to handle confidential or sensitive information with discretion
- Proficiency in Microsoft Office

Opportunities:
- Opportunity to contribute to the healthcare industry by ensuring accurate claims processing and customer satisfaction
- Potential for career growth and advancement within the company
- Collaborative work environment with a focus on teamwork and professional development

Company Culture:
At Kelly® Professional & Industrial, we value our employees and believe in providing a supportive and inclusive work environment. We are committed to helping our employees discover their potential and grow in their careers. Join our team and be part of a premiere company that values your skills and contributions.

What happens next:
If your skills and experience align with the requirements of this position, you will proceed to the next steps in the application process. Even if this particular position doesn't work out, your profile will remain in our network, giving you access to a wide range of opportunities.

Helping you discover what's next in your career is our priority. Apply today to be a Customer Service Professional and let's work together towards your professional growth.
As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account. In addition, employees are entitled to earn paid sick leave under the applicable state or local plan. Click here for more information on benefits and perks that may be available to you as a member of the Kelly Talent Community.

Get a complete career fit with Kelly®.

You’re looking to keep your career moving onward and upward, and we’re here to help you do just that. Our staffing experts connect you with top companies for opportunities where you can learn, grow, and thrive. Jobs that fit your skills and experience, and most importantly, fit right on your path of where you want to go in your career.

About Kelly

Work changes everything. And at Kelly, we’re obsessed with where it can take you. To us, it’s about more than simply accepting your next job opportunity. It’s the fuel that powers every next step of your life. It’s the ripple effect that changes and improves everything for your family, your community, and the world. Which is why, here at Kelly, we are dedicated to providing you with limitless opportunities to enrich your life—just ask the 300,000 people we employ each year.

Kelly Services is proud to be an Equal Employment Opportunity and Affirmative Action employer. We welcome, value, and embrace diversity at all levels and are committed to building a team that is inclusive of a variety of backgrounds, communities, perspectives, and abilities. At Kelly, we believe that the more inclusive we are, the better services we can provide. Requests for accommodation related to our application process can be directed to Kelly’s Human Resource Knowledge Center. Kelly complies with the requirements of California’s state and local Fair Chance laws. A conviction does not automatically bar individuals from employment.