Claims Technician

BlueCross BlueShield of South Carolina•Florence, SC

1d•Onsite

About The Position

Performs routine but varied clerical duties in accordance with standard procedures. This includes clerical duties such as photocopying, compiling records, filing, tabulating, posting information, distributing mail, screening, scanning, data element verification and document indexing. Applies knowledge of department policies and procedures and utilizes a general understanding of other departments' functions. Maintains records, prepares forms, verifies information and resolves routine problems. Ensures claims are processed in a timely manner. Description Logistics: PGBA – one of BlueCross BlueShield's South Carolina subsidiary companies Location: This position is full-time (40-hours/week) Monday-Friday from 8:00am-5:00pm in a typical office environment. This role is located on-site at 200 North Dozier Boulevard Florence, SC 29501. Government Clearance : This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. 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. What You’ll Do: Receives, opens, sorts and distributes incoming departmental mail or work requests. Checks workflow documents to ensure required information is available. Requests any missing documentation as needed. Scans all documents for storage in the electronic repository. Prepares correspondence or packages for internal/external mailing. Screens and verifies information. Ensures proper and accurate processing flow of all paper claims and correspondence in accordance with department standards for quality and production, contract regulations, policies and guidelines. Conducts data element verification of data elements for those that fail the mapping process prior to claims adjudication. Applies appropriate indexes as needed to claims and/or correspondence. Maintains departmental logs, spreadsheets or databases. Effectively uses all available reference materials in performance of daily functions. Keeps track of supply inventory and/or orders supplies as needed.

Requirements

High School Diploma or equivalent
Strong organizational and analytical skills.
Good communication and organizational skills.
Detail-oriented.
Ability to handle confidential or sensitive information with discretion.

Nice To Haves

Ability to accurately key 5000 ksph or 30 wpm.
Knowledgeable in word processing and spreadsheet applications.

Responsibilities

Receives, opens, sorts and distributes incoming departmental mail or work requests.
Checks workflow documents to ensure required information is available.
Requests any missing documentation as needed.
Scans all documents for storage in the electronic repository.
Prepares correspondence or packages for internal/external mailing.
Screens and verifies information.
Ensures proper and accurate processing flow of all paper claims and correspondence in accordance with department standards for quality and production, contract regulations, policies and guidelines.
Conducts data element verification of data elements for those that fail the mapping process prior to claims adjudication.
Applies appropriate indexes as needed to claims and/or correspondence.
Maintains departmental logs, spreadsheets or databases.
Effectively uses all available reference materials in performance of daily functions.
Keeps track of supply inventory and/or orders supplies as needed.