Claims Processor I - PGBA

BlueCross BlueShield of South Carolina•Florence, SC

7d•Onsite

About The Position

We are currently hiring for a Claims Processor I to join BlueCross BlueShield of South Carolina. You will be responsible for the accurate and timely processing of claims. 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! Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.

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.