Detail-Oriented Claims Processor I

Pgba, Llc; Myrtle Beach (SC); On-site; USD 36,000 - 48,000; Full time

Benefits offered by this job

Health insurance

401k retirement savings with company 1

Life Insurance

Paid Time Off (PTO)

On-site cafeterias and fitness centers

Education Assistance

Service Recognition

National discounts

Job summary

BlueCross BlueShield of South Carolina seeks a dedicated claims processor to ensure accurate, timely processing of insurance claims in a 40-hour workweek. On-site at Myrtle Beach, SC, the role requires ability to obtain a security clearance as a U.S. citizen.

Responsibilities include researching and resolving claim edits, verifying coding accuracy, and coordinating with internal departments to update records and deferrals. Strong analytical and communication skills are essential.

Qualifications

• Researches and processes claims according to regulations and guidelines.
• Verifies coding of procedures and diagnoses.
• Resolves system edits and errors through investigation and reference sources.
• Coordinates with internal departments to update patient and insurer files.

Responsibilities

• Researches and processes claims according to business regulation, internal standards and processing guidelines.
• Verifies the coding of procedure and diagnosis codes.
• Resolves system edits, audits and claims errors through research and use of approved references and investigative sources.
• Coordinates with internal departments to work edits and deferrals, updating the patient identification and other files as necessary.

Skills

Analytical

Organizational

Customer service

Oral and written communication

Spelling and grammar

Judgment

Basic math

Education

High School Diploma or equivalent

Tools

Word processing

Spreadsheets

Database software

Basic office equipment

Job description

BlueCross BlueShield of South Carolina seeks a dedicated claims processor to ensure accurate, timely processing of insurance claims in a 40-hour workweek. On-site at Myrtle Beach, SC, the role requires ability to obtain a security clearance as a U.S. citizen.

Responsibilities include researching and resolving claim edits, verifying coding accuracy, and coordinating with internal departments to update records and deferrals. Strong analytical and communication skills are essential.