Claims Processing 1-18

BlueCross BlueShield of South Carolina•Florence, SC

21d•Onsite

About The Position

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. We are the largest insurance company in South Carolina … and much more. We are one of the nation’s leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Position Purpose: Responsible for the accurate and timely processing of claims. Location: This position is full-time (40 hours/week) Monday-Friday from 8:00am-5:00pm. This role is located on-site at 200 N Dozier Blvd., Florence, SC 29501. SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). Under the McNamara-O'Hara Service Contract Act (SCA), employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date.

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.

Nice To Haves

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

Responsibilities

Researches and processes claims according to business regulation, internal standards and processing guidelines.
Verifies the coding of procedure and diagnosis codes.
Resolves system edits, audits and claims errors through research and use of approved references and investigative sources.
Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.