Efficient Claims Processing Specialist

ourhrconnect; Florence (SC); On-site; USD 36,000 - 52,000; Full time

Benefits offered by this job

Subsidized health plans

Dental and vision coverage

401k retirement savings with company

Life Insurance

Paid Time Off

On-site cafeterias and fitness centers

Job summary

BlueCross BlueShield of South Carolina is seeking a Claims Processor to ensure accurate and timely processing of claims in a full-time, on-site role based in Florence, SC. The position runs Monday–Friday, 8am–5pm, in a typical office environment.

You will research and process claims per regulations and guidelines, verify coding accuracy, resolve edits, and collaborate with internal departments to update patient information and other health insurance and provider data as needed.

Qualifications

• Strong analytical, organizational and customer service skills.
• Strong oral and written communication skills.
• Proficient spelling, punctuation and grammar skills.
• Good judgment skills.
• Basic business math skills.

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 patient identification and other files as necessary.

Skills

Analytical skills

Organizational skills

Customer service skills

Oral and written communication

Spelling and grammar

Judgment

Basic math

Education

High School Diploma or equivalent

Tools

Basic office equipment

Job description

BlueCross BlueShield of South Carolina is seeking a Claims Processor to ensure accurate and timely processing of claims in a full-time, on-site role based in Florence, SC. The position runs Monday–Friday, 8am–5pm, in a typical office environment.

You will research and process claims per regulations and guidelines, verify coding accuracy, resolve edits, and collaborate with internal departments to update patient information and other health insurance and provider data as needed.