Claims Processor I

BlueCross BlueShield of South Carolina•Florence, SC

2d•Onsite

About The Position

Responsible for the accurate and timely processing of claims. BlueCross BlueShield of South Carolina has been part of the national landscape for more than seven decades, with roots firmly embedded in the South Carolina community. They are the largest insurance company in South Carolina and a leading administrator of government contracts, operating a sophisticated data processing center. This full-time position (40-hours/week) is located onsite at 200 North Dozier Boulevard Florence, SC 29501, with typical office hours of 8:00 AM – 5:00 PM, Monday-Friday. This role requires the ability to obtain a security clearance, necessitating U.S. Citizenship. As an employee subject to the Service Contract Act (SCA), enrollment in their health insurance is required, with supplemental pay provided until enrollment is complete. Coverage begins the first day of the month following 28 days of full-time employment.

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.
U.S. Citizen (for security clearance)

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.