Part-Time Claims Specialist: Accurate, Timely Processing

Pgba, Llc; Florence (SC); Hybrid; USD 15,000 - 21,000; Part time

Benefits offered by this job

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

Job summary

PGBA, LLC, a leading administrator for TRICARE and SC health programs, is seeking a part-time Claims Processor I in Florence, SC. The role emphasizes accurate and timely processing of insurance claims in a busy office environment.

Responsibilities include researching and processing claims, verifying coding accuracy, resolving system edits, and coordinating with internal departments to correct records and deferrals. Training will run five weeks, 8am-4:30pm, Monday to Friday.

Qualifications

• High School diploma or equivalent is required.
• Strong analytical, organizational and customer service skills are required.
• Excellent oral and written communication and grammar are essential.
• Good judgment and basic business math skills are required.

Responsibilities

• Researches and processes claims according to regulations, standards and processing guidelines; verifies coding of procedures and diagnoses.
• Resolves system edits, audits and claims errors through research and approved references.
• Coordinates with internal departments to work edits/deferrals and updates patient and insurer records as necessary.

Skills

Strong analytical

Organizational skills

Customer service skills

Oral and written communication

Spelling punctuation and grammar

Good judgment

Basic math

Education

High School Diploma or equivalent

Tools

Word processing

Spreadsheets

Database software

Basic office equipment

Job description

PGBA, LLC, a leading administrator for TRICARE and SC health programs, is seeking a part-time Claims Processor I in Florence, SC. The role emphasizes accurate and timely processing of insurance claims in a busy office environment.

Responsibilities include researching and processing claims, verifying coding accuracy, resolving system edits, and coordinating with internal departments to correct records and deferrals. Training will run five weeks, 8am-4:30pm, Monday to Friday.