Claims Processor I - Detail-Oriented & Growth-Ready

Pgba, Llc; Columbia, Northern (SC, KY); Hybrid; USD 38,000 - 60,000; Full time

Benefits offered by this job

401k retirement savings plan

Paid Time Off

On-site cafeterias and fitness centers

Education Assistance

Job summary

BlueCross BlueShield of South Carolina is seeking a dedicated Claims Processor in Columbia, SC, to ensure accurate, timely processing of claims in a 40-hour workweek. The role requires attention to detail, information accuracy, and collaboration with internal teams.

You will verify procedure and diagnosis code accuracy, resolve system edits, and coordinate with departments to manage patient and payer data while maintaining compliance with regulations and internal standards.

Qualifications

• High School Diploma or equivalent.
• 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 regulations and guidelines.
• Verifies the coding of procedure and diagnosis codes.
• Resolves system edits, audits and claims errors through research and approved references.
• Coordinates with internal departments to work edits and deferrals, updating patient identification and insurance files.

Skills

Analytical skills

Organizational skills

Customer service

Oral communication

Written communication

Spelling & grammar

Judgment

Basic math

Education

High school diploma

Tools

Word processing

Spreadsheets

Database software

Job description

BlueCross BlueShield of South Carolina is seeking a dedicated Claims Processor in Columbia, SC, to ensure accurate, timely processing of claims in a 40-hour workweek. The role requires attention to detail, information accuracy, and collaboration with internal teams.

You will verify procedure and diagnosis code accuracy, resolve system edits, and coordinate with departments to manage patient and payer data while maintaining compliance with regulations and internal standards.