Claims Processor I - PGBA

Summary We are currently hiring for a Claims Processor I to join Blue Cross Blue Shield of South Carolina. You will be responsible for the accurate and timely processing of claims.

Why should you join the Blue Cross Blue Shield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, 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 that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!

Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.

Description Location : PGBALogistics:

This position is a full-time Mon
- Friday 8:00am to 5:00pm in a typical office environment. It may be necessary, given the business need to work occasional overtime and weekends. This position is located onsite at 200 North Dozier Boulevard, Florence, SC 29501.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:

Required

Education:

High School Diploma or equivalent

Required

Work Experience:

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:

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.

Work Environment:
Typical office or home environment.

Our Comprehensive Benefits Package Includes the Following:

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.

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. 'What To Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.

Equal Employment Opportunity Statement Blue Cross  Blue Shield 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…