Claims Processor

Position: Claims Processor I
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*
* 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.
*** 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.
* ** 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.
* ** 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**.
*** 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
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