Claims Processor I — Detail‑Oriented, On‑Site in Myrtle Beach

Pgba, Llc; Myrtle Beach (SC); On-site; USD 42,000 - 54,000; Full time

Job summary

BlueCross BlueShield of South Carolina’s PGBA unit seeks a Processor, Claims IApply for an on-site, full-time role in Myrtle Beach.

You will research and process claims, verify coding, and resolve edits using approved references to ensure accurate payments.

The position requires a high school diploma and strong analytical/communication skills, with US citizenship for security clearance.

Qualifications

• High School Diploma or equivalent required.
• Strong analytical, organizational and customer service skills.
• Excellent oral and written communication; strong spelling and grammar.
• Good judgment and basic business math.
• Proficient in word processing, spreadsheets, and database software.

Responsibilities

• Researches and processes claims according to regulations and guidelines.
• Verifies the coding of procedure and diagnosis codes.
• Resolves system edits, audits and claim errors through research and approved references.
• Coordinates with internal departments to work edits and deferrals and update patient/provider data as needed.

Skills

Analytical skills

Customer service

Oral & written comms

Grammar & spelling

Judgment

Business math

Education

High School Diploma or equivalent

Tools

Word processing

Spreadsheets

Database software

Job description

BlueCross BlueShield of South Carolina’s PGBA unit seeks a Processor, Claims IApply for an on-site, full-time role in Myrtle Beach.

You will research and process claims, verify coding, and resolve edits using approved references to ensure accurate payments.

The position requires a high school diploma and strong analytical/communication skills, with US citizenship for security clearance.