On-Site Claims Processor - Detail-Driven Specialist

Pgba, Llc; Florence (SC); On-site; USD 36,000 - 54,000; Full time

Benefits offered by this job

Subsidized health plans

Dental and vision coverage

401k retirement savings with company  

Life Insurance

Paid Time Off (PTO)

On-site cafeterias and fitness centers

Education Assistance

Service Recognition

National discounts

Job summary

BlueCross BlueShield of South Carolina - PGBA seeks a detail-oriented Claims Processor I to accurately process healthcare claims on-site in Florence, SC. The role supports regulatory compliance and maintains timely claim adjudication.

The position requires strong analytical skills, solid communication, and basic math ability; prior healthcare or insurance exposure is a plus. On-site schedule is Monday–Friday, 8:00am–5:00pm, with comprehensive benefits.

Qualifications

• High school diploma or equivalent is required.
• Strong analytical, organizational and customer service skills are essential.
• Good oral and written communication skills and attention to detail are important.
• Proficient spelling, punctuation and grammar.
• Basic business math and sound judgment are needed.

Responsibilities

• Researches and processes claims according to regulations and guidelines.
• Verifies coding of procedures and diagnoses.
• Resolves system edits and claims errors through research and approved references.
• Coordinates with internal departments to work edits/deferrals and update patient/file information.

Skills

Analytical skills

Organizational skills

Customer service

Oral and written communication

Spelling, punctuation, grammar

Good judgment

Basic math

Education

High School Diploma or equivalent

Tools

Word processing

Spreadsheet software

Database software

Basic office equipment

Job description

BlueCross BlueShield of South Carolina - PGBA seeks a detail-oriented Claims Processor I to accurately process healthcare claims on-site in Florence, SC. The role supports regulatory compliance and maintains timely claim adjudication.

The position requires strong analytical skills, solid communication, and basic math ability; prior healthcare or insurance exposure is a plus. On-site schedule is Monday–Friday, 8:00am–5:00pm, with comprehensive benefits.