Complex Claims Processor II

Southcarolinablues; Columbia, Northern (SC, KY); Hybrid; USD 42,000 - 56,000; Full time

Benefits offered by this job

On-site cafeterias and fitness centers

Education Assistance

Paid Time Off

Job summary

BlueCross BlueShield of South Carolina is seeking a Processor, Claims IIApply in Columbia, SC. This full-time, on-site role handles complex and specialty claims, verifies coding, and ensures quality processing.

The role supports training and mentoring, requiring a high school diploma and 2 years of claims processing experience. Office hours are standard, with security clearance considerations for federal contracting work.

Qualifications

• High School Diploma or equivalent required.
• 2 years of experience processing, researching and adjudicating claims preferred.

Responsibilities

• Examines and processes complex or specialty claims according to regulations and guidelines.
• Enters claims into the system, verifies coding of procedures and diagnoses.
• Ensures processing meets quality and production standards; corrects errors by reprocessing or recouping claims.
• Resolves claim edits and deferrals and researches problems with internal teams.

Skills

Analytical skills

Organizational skills

Communication skills

Discretion

Attention to detail

Basic math

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina is seeking a Processor, Claims IIApply in Columbia, SC. This full-time, on-site role handles complex and specialty claims, verifies coding, and ensures quality processing.

The role supports training and mentoring, requiring a high school diploma and 2 years of claims processing experience. Office hours are standard, with security clearance considerations for federal contracting work.