Claims Processor I - Detail-Driven Claims & Coding

Southcarolinablues; Columbia, Northern (SC, KY); Hybrid; USD 38,000 - 48,000; Full time

Benefits offered by this job

Subsidized health plans

Dental and vision coverage

401k with company match

Life Insurance

Paid Time Off

On-site cafeterias and fitness centers

Education assistance

Service recognition

National discounts

Job summary

BlueCross BlueShield of South Carolina is seeking a Claims Processor I for an on-site role in Columbia, SC. The position handles accurate and timely processing of claims, verifies procedure and diagnosis codes, resolves edits, and coordinates with internal teams to update patient and provider information. Monday–Friday, 8:00am–5:00pm in a typical office setting.

Requires a high school diploma or equivalent and the ability to obtain a security clearance as a U.S. citizen.

Qualifications

• High School Diploma or equivalent required.
• Strong analytical, organizational and customer service skills.
• Strong oral and written communication skills.
• Proficient spelling, punctuation and grammar.
• Good judgment; basic business math.

Responsibilities

• Researches and processes claims according to regulations, standards and processing guidelines.
• Verifies coding of procedure and diagnosis codes.
• Resolves system edits, audits and claims errors through research and references.
• Coordinates with internal departments to work edits and deferrals and update patient and provider information.

Skills

Analytical skills

Organizational skills

Customer service

Oral and written communication

Spelling, grammar

Judgment

Basic math

Education

High school diploma or equivalent

Tools

Word processing

Spreadsheet applications

Database software

Basic office equipment

Job description

BlueCross BlueShield of South Carolina is seeking a Claims Processor I for an on-site role in Columbia, SC. The position handles accurate and timely processing of claims, verifies procedure and diagnosis codes, resolves edits, and coordinates with internal teams to update patient and provider information. Monday–Friday, 8:00am–5:00pm in a typical office setting.

Requires a high school diploma or equivalent and the ability to obtain a security clearance as a U.S. citizen.