Claims Processor I

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

What You'll Do:

• Research and process claims according to business regulation, internal standards and processing guidelines. Verifies the coding of procedure and diagnosis codes.

• Resolve system edits, audit and claim errors through research and use of approved references and investigative sources.

• Coordinate 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

• 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.

We Prefer You to Have:

• 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 Blue Can Do for You:    

We understand the value of a diverse and inclusive workplace.  We strive to be an employer across all spectrums where employees can develop their skills, advance their careers, and contribute their unique abilities to the growth of our company.

Our comprehensive benefits package includes:

• 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

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.