Claims Resolution Specialist II – On-Site in Columbia

Southcarolinablues; Columbia (SC); On-site; USD 42,000 - 65,000; Full time

Benefits offered by this job

Health insurance

401K

Paid Time Off

On-site cafeterias

Job summary

BlueCross BlueShield of South Carolina is seeking an Claims Customer Service Advocate II to handle routine to complex claims and appeals on-site in Columbia, SC. The role includes reviewing and adjudicating claims, entering data, and ensuring accuracy against regulations.

The position requires 40 hours/week, with training on-site for 6-8 weeks, and eligibility for health benefits after 28 days of employment.

Qualifications

• High school diploma or equivalent.
• 2 years of claims processing, researching, and adjudicating.
• Strong communication, organizational and analytical abilities.
• Proficient in Microsoft Office.

Responsibilities

• Examin es and processes complex or specialty claims according to regulations and procedures.
• Enters claims into the claim system after verification of proper coding.
• Verifies claims are keyed correctly and meet quality/production standards.
• Researches claim problems using policies and coordinating with internal support areas.
• Responds to routine correspondence and maintains related spreadsheets.

Skills

Organizational

Analytical skills

Written communication

Grammar proficiency

Basic math

Confidentiality

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina is seeking an Claims Customer Service Advocate II to handle routine to complex claims and appeals on-site in Columbia, SC. The role includes reviewing and adjudicating claims, entering data, and ensuring accuracy against regulations.

The position requires 40 hours/week, with training on-site for 6-8 weeks, and eligibility for health benefits after 28 days of employment.