On-Site Claims Specialist – Processing & Research (Myrtle Beach)

Pgba, Llc; Myrtle Beach (SC); Presencial; USD 36.000 - 52.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Subsidized health plans

Dental and vision coverage

401k with company match

Life Insurance

Paid Time Off

On-site cafeterias and fitness centers

Education Assistance

Service Recognition

National discounts

Descripción de la vacante

BlueCross BlueShield of South Carolina is seeking a claims processor for an on-site, full-time role in Myrtle Beach. The position requires research and processing of claims, coding verification, and coordination with internal teams to correct edits or deferrals.

A high school diploma is required, with strong analytical and communication skills essential for success. The role operates 8:00am–5:00pm, Monday–Friday, at our Myrtle Beach location, with eligibility for a comprehensive benefits package

Formación

• 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.
• High School Diploma or equivalent is required.

Responsabilidades

• Researches and processes claims according to business regulation, internal standards and processing guidelines.
• Verifies coding of procedure and diagnosis codes.
• Resolves system edits, audits and claims errors through research and use of approved references.
• Coordinates with internal departments to coordinate edits and deferrals and update patient/insurance/provider information.

Conocimientos

Analytical skills

Organizational skills

Customer service

Oral and written communication

Spelling/grammar

Judgment

Basic math

Educación

High School Diploma or equivalent

Herramientas

Basic office equipment

Word processing

Spreadsheets

Database software

Descripción del empleo

BlueCross BlueShield of South Carolina is seeking a claims processor for an on-site, full-time role in Myrtle Beach. The position requires research and processing of claims, coding verification, and coordination with internal teams to correct edits or deferrals.

A high school diploma is required, with strong analytical and communication skills essential for success. The role operates 8:00am–5:00pm, Monday–Friday, at our Myrtle Beach location, with eligibility for a comprehensive benefits package