Claims Processing Specialist - Healthcare Claims Expert

BlueCross and BlueShield of South Carolina; Florence (SC); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Health and dental benefits

401k retirement plan with companyMatch

PTO

On-site cafeterias and fitness centers

Education assistance

Service recognition

National discounts

Job summary

BlueCross BlueShield of South Carolina is seeking aClaims Processor to ensure accurate and timely processing of insurance claims at our Florence, SC site. This full-time, on-site role supports our commitment to delivering quality service to members and providers.

You will verify coding, resolve edits, and collaborate with internal teams to maintain complete and compliant claim records, with typical 8:00am-5:00pm hours Monday through Friday.

Qualifications

• High school diploma or equivalent required.
• At least 1 year of healthcare or insurance experience preferred.
• Proficiency with word processing and spreadsheet software; database skills help.
• Strong analytical, organizational and communication skills.

Responsibilities

• Researches and processes claims according to regulations, 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 patient and provider information as necessary.

Skills

Analytical skills

Organizational skills

Customer service

Oral communication

Written communication

Spelling and grammar

Judgment

Basic math

Education

High School Diploma or equivalent

Tools

Basic office software

Job description

BlueCross BlueShield of South Carolina is seeking aClaims Processor to ensure accurate and timely processing of insurance claims at our Florence, SC site. This full-time, on-site role supports our commitment to delivering quality service to members and providers.

You will verify coding, resolve edits, and collaborate with internal teams to maintain complete and compliant claim records, with typical 8:00am-5:00pm hours Monday through Friday.