On-Site Claims Processing Specialist I

Southcarolinablues; Florence (SC); On-site; USD 34,000 - 46,000; Full time

Job summary

BlueCross BlueShield of South Carolina, through its PGBA subsidiary, seeks a Claims Processor I to handle the accurate and timely processing of medical claims in Florence, SC. This full-time, on-site role runs Monday through Friday, 8am-5pm, at 200 N Dozier Blvd.

You will verify procedure and diagnosis codes, resolve edits, and coordinate with internal departments to update records. A high school diploma is required; strong analytical, communication, and math skills are essential, with

Qualifications

• High School Diploma or equivalent.
• 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 related files.

Skills

Analytical skills

Organizational skills

Customer service

Communication skills

Grammar

Good judgment

Basic math

Education

High School Diploma or equivalent

Tools

Office equipment

Word processing

Spreadsheet software

Database software

Job description

BlueCross BlueShield of South Carolina, through its PGBA subsidiary, seeks a Claims Processor I to handle the accurate and timely processing of medical claims in Florence, SC. This full-time, on-site role runs Monday through Friday, 8am-5pm, at 200 N Dozier Blvd.

You will verify procedure and diagnosis codes, resolve edits, and coordinate with internal departments to update records. A high school diploma is required; strong analytical, communication, and math skills are essential, with