Healthcare Claims Processor I

Pgba, Llc; Columbia, Northern (SC, KY); Hybrid; USD 40,000 - 62,000; Full time

Benefits offered by this job

Subsidized health plans

401k with company match

PTO

Job summary

PGBA, LLC in Columbia, SC is seeking a detail-oriented Claims Processor to ensure accurate and timely processing of healthcare claims. The role is full-time, 40 hours/week, Monday–Friday, 8am–5pm, on-site at 17 Technology Cir, Columbia, SC 29203.

Candidates must be a U.S. citizen and able to obtain a security clearance. Benefits include substantial health plans, 401k with company match, PTO, and more, as part of a comprehensive package.

Qualifications

• High School Diploma or equivalent.
• 1 year of healthcare or insurance experience preferred.
• Strong analytical, organizational, and customer service abilities.
• Proficient spelling, punctuation, and grammar.
• Ability to obtain security clearance.

Responsibilities

• Research and process claims according to regulations and guidelines.
• Verifies the coding of procedure and diagnosis codes.
• Resolves system edits, audits, and claim errors through research and approved references.
• Coordinates with internal departments to work edits and deferrals and update patient and provider information.

Skills

Analytical skills

Organizational skills

Customer service

Oral and written communication

Spelling & grammar

Judgment

Basic math

Education

High School Diploma or equivalent

Tools

Word processing

Spreadsheet

Database basics

Job description

PGBA, LLC in Columbia, SC is seeking a detail-oriented Claims Processor to ensure accurate and timely processing of healthcare claims. The role is full-time, 40 hours/week, Monday–Friday, 8am–5pm, on-site at 17 Technology Cir, Columbia, SC 29203.

Candidates must be a U.S. citizen and able to obtain a security clearance. Benefits include substantial health plans, 401k with company match, PTO, and more, as part of a comprehensive package.