Claims Processor I

3 weeks ago


Myrtle Beach, South Carolina, United States PGBA Full time
Job Summary

We are seeking a highly skilled Claims Processor I to join our team at BlueCross BlueShield of South Carolina. As a Claims Processor I, you will be responsible for accurately and efficiently processing claims in accordance with business regulations, internal standards, and processing guidelines.

Key Responsibilities
  • Research and process claims in a timely manner
  • Verify coding of procedure and diagnosis codes
  • Resolve system edits, audits, and claims errors through research and use of approved references and investigative sources
  • Coordinate with internal departments to work edits and deferrals, updating patient identification, other health insurance, provider identification, and other files as necessary
Requirements
  • 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
Preferred Qualifications
  • 1 year of experience in a healthcare or insurance environment
  • Ability to use complex mathematical calculations
  • Proficiency in word processing and spreadsheet applications
  • Proficiency in database software
Work Environment

This is a full-time, on-site position in a typical office environment. Training will be provided, and employees are required to work from 8:00 AM to 5:00 PM. Occasional overtime and weekends may be necessary.

Benefits
  • 401(k) retirement savings plan with company match
  • Subsidized health plans and free vision coverage
  • Life insurance
  • Paid annual leave
  • Nine paid holidays
  • On-site cafeterias and fitness centers
  • Wellness programs
  • Tuition assistance
  • Service Recognition

We are an equal opportunity employer and participate in E-Verify. 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, please contact us at [insert contact information].


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