Claims Specialist I - Entry Level

001 BlueCross and BlueShield of South Carolina; Florence (SC); Presencial; USD 38.000 - 52.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Subsidized health plans

Dental and vision coverage

401k with company match

Life Insurance

PTO

On-site cafeterias and fitness centers

Education Assistance

Service Recognition

Discounts

Descripción de la vacante

PGBA, LLC is seeking a detail-oriented Claims Processor to ensure accurate and timely processing of medical claims. This full-time, on-site role is based at 200 N Dozier Blvd, Florence, SC, with hours Monday–Friday, 8am–5pm.

Responsibilities include researching and processing claims, coding verification, and resolving system edits while coordinating with internal departments. A high school diploma is required; comprehensive benefits are provided.

Formación

• Researches and processes claims according to business regulations, standards and guidelines.
• Verifies coding of procedure and diagnosis codes.
• Resolves system edits, audits and claims errors through investigation and references.

Responsabilidades

• Coordinates with internal departments to work edits and deferrals, updating patient and insurance data as needed.
• Provides accurate and timely claim processing to meet service level expectations.

Conocimientos

Analytical skills

Organizational skills

Customer service

Educación

High School Diploma or equivalent

Herramientas

Word processing

Spreadsheets

Database software

Descripción del empleo

PGBA, LLC is seeking a detail-oriented Claims Processor to ensure accurate and timely processing of medical claims. This full-time, on-site role is based at 200 N Dozier Blvd, Florence, SC, with hours Monday–Friday, 8am–5pm.

Responsibilities include researching and processing claims, coding verification, and resolving system edits while coordinating with internal departments. A high school diploma is required; comprehensive benefits are provided.