Claims Processor I

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

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

Logistics:

This is a fully onsite position located in Columbia, South Carolina. New hire training class 01/08/2025.

What You'll Do:

Research 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:

• 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.
• Basic office equipment.

What we Prefer:

• 1 year-of experience in a healthcare or insurance environment.
• Ability to use complex mathematical calculations.
• Proficient in word processing and spreadsheet applications.
• Proficient in database software.

What We can Do for You:

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
• Wellness program and healthy lifestyle premium discount
• Tuition assistance
• Service recognition
• Employee Assistance
• Discounts to movies, theaters, zoos, theme parks and more

What to Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure your meet the qualifications.  This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. If the qualifications required proof of semester hours, please attach your transcript to your application.

Management will be conducting interviews with the most qualified candidates, with prioritization give 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 make a determination regarding your request for reasonable accommodation on a case-by-case basis.