Claims Processing I - PGBA-20

Summary
 Responsible for the accurate and timely processing of claims.
Description
 

Logistics:

• This is a full-time (40 HOPW) position.
• Our ideal candidate will be required to work in our Florence, SC location.​

What You Will Do:

• Research and process 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 Will Need:

• Required Education: High School Diploma or equivalent.
• Required Skills: 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 Had:

• 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.

What Blue Can Do for You:

• 401(k) retirement savings plan with company match.
• Subsidized health plans and free vision coverage.
• Life insurance.
• Paid annual leave – the longer you work here, the more you earn.
• Nine paid holidays.
• On-site cafeterias and fitness centers in major locations.
• Wellness programs and healthy lifestyle premium discount.
• Tuition assistance.
• Service recognition.
• Incentive Plan.
• Merit Plan.
• Continuing education funds for additional certifications and certification renewal.

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 a recruiter to verify resume specifics and salary requirements.

Management will be conducting interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.  Some states have required notifications. Here's more information. 

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 minorities, females, disabled individuals, and 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.

We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities.

If you need special assistance or an accommodation while seeking employment, please e-mail [email protected] or call 1-800-288-2227, ext. 47480 with the nature of your request. We will decide regarding your request for reasonable accommodation on a case-by-case basis.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

Some states have required notifications. Here's more information. 

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 minorities, females, disabled individuals and 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.

We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities.

If you need special assistance or an accommodation while seeking employment, please e-mail [email protected] or call 1-800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.