Claims Processor Job Florence area,South Carolina USA,Administrative/Clerical

Summary

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 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 Blue Cross Blue Shield's South Carolina subsidiary companies.

Location

This position is full-time (40 hours/week) Monday-Friday from 8:00am-5:00pm. This role is located on-site at 200 N Dozier Blvd., Florence, SC 29501.

SCA Benefit Requirements

Blue Cross Blue Shield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). Under the McNamara-O'Hara Service Contract Act (SCA), employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 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

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…