Processor, Claims I

ourhrconnect; Myrtle Beach (SC); On-site; USD 32,000 - 42,000; Full time

Benefits offered by this job

Subsidized health plans

Dental and vision coverage

401k retirement savings plan with公司

Job summary

BlueCross BlueShield of South Carolina is seeking a claims processing professional to ensure accurate and timely processing of claims in a standard office environment at our Myrtle Beach location.

You will research and process claims, verify procedure and diagnosis codes, resolve edits and errors, and coordinate with internal departments to update patient and provider records, while delivering dependable, customer-focused service.

Qualifications

• High School Diploma or equivalent required.
• Strong analytical, organizational and customer service skills.
• Ability to verify codes and handle basic math.

Responsibilities

• Researches and processes claims according to regulations and guidelines; verifies codes.
• Resolves system edits and errors using approved references.
• Coordinates with internal departments to update patient and provider records.

Skills

Analytical skills

Organizational skills

Customer service

Oral & written communication

Spelling, punctuation, grammar

Good judgment

Basic business math

Education

High School Diploma or equivalent

Tools

Office equipment

Job description

Summary

Responsible for the accurate and timely processing of claims.

Description

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!

Position Purpose

Responsible for the accurate and timely processing of claims.

Logistics

PGBA - one of BlueCross BlueShield's South Carolina subsidiary companies

Location

This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role is located on-site at 8733 Highway 17 Bypass, Myrtle Beach, SC, 29575.

Government Clearance

This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen.

SCA Benefit Requirements

BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act ( SCA ). To comply with the McNamara-O'Hara Service Contract Act (SCA), employees must enroll in our health insurance even if they have other health insurance. Employees will receive supplemental pay for health insurance until they are enrolled in our health insurance, first of the month following 28 days after the hire date.

Sponsorship

This position is not eligible for sponsorship now or in the future.

What You'll Do

• 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.

To Qualify for This Position, You'll Need the Following:

Required Education

High School Diploma or equivalent

Required Skills and Abilities

• 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 .

Required Software and Tools

Basic office equipment.

We Prefer That You Have the Following:

Preferred Work Experience

1 year-of experience in a healthcare or insurance environment.

Preferred Skills and Abilities

Ability to use complex mathematical calculations.

Preferred Software and Other Tools

• Proficient in word processing and spreadsheet applications.
• Proficient in database software.

Our Comprehensive Benefits Package Includes the Following:

• Subsidized health plans, dental and vision coverage
• 401k retirement savings plan with company match
• Life Insurance
• Paid Time Off (PTO)
• On-site cafeterias and fitness centers in major locations
• Education Assistance
• Service Recognition
• National discounts to movies, theaters, zoos, theme parks and more

What We Can Do for You

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.