Claims Adjudication Specialist

001 BlueCross and BlueShield of South Carolina; Myrtle Beach (SC); On-site; USD 22,000 - 30,000; Part time

Benefits offered by this job

Health insurance

401K retirement savings

Paid Time Off

On-site fitness centers

Tuition assistance

Job summary

BlueCross BlueShield of South Carolina is seeking a dedicated claims processor to accurately and promptly process complex or specialty claims in a full-time environment. The role requires attention to coding accuracy, adherence to policies, and collaboration with internal support teams.

Responsibilities include entering and verifying claims, correcting processing errors, and responding to routine correspondence. Training will occur onsite, with potential overtime as needed.

Qualifications

• Two years of experience processing, researching, and adjudicating claims.
• High School Diploma or equivalent required.
• Strong proficiency with Microsoft Office and data entry.

Responsibilities

• Examines and processes complex or specialty claims.
• Enters claims into the claim system after verification of correct coding.
• Verifies that claims have been keyed correctly and processed per standards.
• Ensures claims are processed according to quality and production standards.
• Corrects processing errors by reprocessing, adjusting, or recouping claims.
• Researches and resolves claim edits and deferrals.
• Responds to routine correspondence and maintains spreadsheets.

Skills

Organizational skills

Analytical skills

Judgment skills

Oral communication

Written communication

Spelling & grammar

Basic math

Confidentiality

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina is seeking a dedicated claims processor to accurately and promptly process complex or specialty claims in a full-time environment. The role requires attention to coding accuracy, adherence to policies, and collaboration with internal support teams.

Responsibilities include entering and verifying claims, correcting processing errors, and responding to routine correspondence. Training will occur onsite, with potential overtime as needed.