Claims Processing Specialist

Southcarolinablues; Florence (SC); Hybrid; USD 34,000 - 52,000; Full time

Benefits offered by this job

Subsidized health plans

401k retirement savings plan with公司匹配

Life Insurance

Paid Time Off (PTO)

On-site cafeterias and fitness centers

Education Assistance

Service Recognition

National discounts

Job summary

BlueCross BlueShield of South Carolina is seeking a detail-oriented professional to accurately process claims in a full-time, on-site role at our Florence, SC location. You will verify procedure and diagnosis codes, research and resolve edits and errors, and coordinate with internal teams to update patient and coverage records.

We emphasize strong analytical and communication skills, with a focus on accuracy, customer service, and compliance with applicable regulations.

Qualifications

• 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.

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.

Skills

Analytical skills

Organizational skills

Customer service skills

Oral & written communication

Spelling, punctuation & grammar

Good judgment

Basic business math

Education

High School Diploma or equivalent

Tools

Basic office equipment

Job description

BlueCross BlueShield of South Carolina is seeking a detail-oriented professional to accurately process claims in a full-time, on-site role at our Florence, SC location. You will verify procedure and diagnosis codes, research and resolve edits and errors, and coordinate with internal teams to update patient and coverage records.

We emphasize strong analytical and communication skills, with a focus on accuracy, customer service, and compliance with applicable regulations.