On-site Claims Specialist I: Precise Processing

Pgba, Llc; Florence (SC); Vor Ort; USD 36.000 - 48.000; Vollzeit

Benefits dieser Stelle

Health plans

Dental & Vision

401k match

Life Insurance

PTO

On-site fitness

Education assistance

Service recognition

National discounts

Zusammenfassung

BlueCross BlueShield of South Carolina is seeking a Claims Processor I for an on-site role in Florence, SC. You will be responsible for accurate and timely processing of claims, applying regulatory guidelines and internal standards in a fast-paced office setting.

The role requires strong analytical abilities, attention to detail, and solid communication skills. You will work with multiple departments to resolve edits and ensure proper patient and provider data handling, with benefits including

Qualifikationen

• 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

Aufgaben

• 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 the patient identification, other health insurance, provider identification and other files as necessary.

Kenntnisse

Analytical skills

Organizational skills

Customer service

Oral & written communication

Spelling & grammar

Good judgment

Basic math

Ausbildung

High School Diploma or equivalent

Tools

Basic office equipment

Jobbeschreibung

BlueCross BlueShield of South Carolina is seeking a Claims Processor I for an on-site role in Florence, SC. You will be responsible for accurate and timely processing of claims, applying regulatory guidelines and internal standards in a fast-paced office setting.

The role requires strong analytical abilities, attention to detail, and solid communication skills. You will work with multiple departments to resolve edits and ensure proper patient and provider data handling, with benefits including