Lead Claims Clerk

033 Palmetto GBA; Columbia (SC); On-site; USD 42,000 - 60,000; Full time

Benefits offered by this job

Subsidized health plans

Dental and vision coverage

401k retirement savings with company s

Life Insurance

Paid Time Off (PTO)

On-site cafeterias and fitness centers

Education assistance

Service recognition

National discounts

Job summary

Palmetto GBA is seeking a claims operations professional to assist management with planning, coordination and assignment of work across staff. You will train new staff, process claims, and support staff with processing methods in a fast-paced environment. The role is full-time, on-site, with hours 8:00AM–5:00PM, at locations in Augusta GA, Florence SC, or Columbia SC.

Sponsorship is not available. Join a leading healthcare administrator and contribute to quality service and efficient claims

Qualifications

• High School Diploma or equivalent required.
• 4 years of experience in a claims operations environment with data entry.
• Strong organizational, judgment, and customer service skills; ability to handle confidential information.
• Proficient with Microsoft Office and typing 5000 KSPH with numeric keypad.
• Preferred: Intermediate in word processing, spreadsheet applications, and database software.

Responsibilities

• Assembles and distributes electronic and hard copy claims to support staff.
• May screen, code and key claims to ensure proper adjudication.
• Processes edits and resolves errors through claims editing software.
• Collects, sorts, and delivers completed claims to the appropriate area.
• Documents errors and other important information throughout claims processing.
• Assists support staff with questions throughout processing.

Skills

Organizational skills

Judgment

Customer service

Attention to detail

Discretion with confidential info

Education

High School Diploma or equivalent

Tools

Microsoft Office

Numeric keypad

Claims editing software

Job description

Summary: Assists management in the planning, coordination, and assignment of work across staff. Trains new staff, and assists staff with the proper processing methods. May screen, code and key claims in claims system.

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!

Position Purpose: Assists management in the planning, coordination, and assignment of work across staff. Trains new staff, and assists staff with the proper processing methods. May screen, code and key claims in claims system.

Logistics: Palmetto GBA – one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is full-time (40 hours/week), Monday-Friday, from 8:00AM to 5:00PM, and will be onsite at one of the following locations: 2743 Perimeter Pkwy, Augusta, GA 30909; 200 N Dozier Blvd, Florence, SC 29501; or 17 Technology Cir, Columbia, SC 29203. Sponsorship: This position is not eligible for sponsorship now or in the future.

What You’ll Do:

• Assembles and distributes electronic and hard copy claims to support staff.
• May screen, code and key claims to ensure proper and accurate adjudication of claims in accordance with departmental standards for quality and production, contract regulations, policies and guidelines.
• Processes edits and resolves errors through claims editing software.
• Collects, sorts, and delivers completed claims to the appropriate area.
• Documents errors and other important information throughout claims processing.
• Assists support staff with questions throughout processing.

To Qualify for This Position, You’ll Need the Following:

• Required Education: High School Diploma or equivalent.
• Required Work Experience: 4 years of experience in a claims operations environment to include data entry experience.
• Required Skills and Abilities: Organizational, judgment, and customer service skills. Ability to handle confidential or sensitive information with discretion. Flexibility to perform multiple functions, strong judgment and attention to detail. Proficient spelling, punctuation, and grammar.
• Required Software and Tools: Microsoft Office. Ability to type a minimum of 5000 KSPH and proficient with numeric keypad.
• We Prefer That You Have the Following:
  • Preferred Software and Other Tools: Intermediate in word processing, spreadsheet applications, and database software.

Our Comprehensive Benefits Package Includes the Following:

• Subsidized health plans
• Dental and vision coverage
• 401k retirement savings plan with company match
• Life Insurance
• Paid Time Off (PTO)
• On-site cafeterias and fitness centers in major locations
• Education Assistance
• Service Recognition
• National discounts to movies, theaters, zoos, theme parks and more

What We Can Do for You:

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

Equal Employment Opportunity Statement BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email [e-mail] or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

Palmetto GBA is a healthcare service administrator and one of the nation’s largest providers of high-volume medical claims and transaction processing. We provide services and technology solutions to improve and streamline healthcare administration not only for government but also for corporate entities. We offer a wide range of services that require a diverse workforce and expansive areas of expertise from data analytics, administrative and workflow services to advanced systems. To help our associates succeed and reach their professional goal, we offer training classes and programs that help employees prepare for leadership positions and offer tuition assistance for education advancement. Palmetto GBA acknowledges associates’ hard work and dedication with awards and financial incentives.