Processor, Claims I
BlueCross BlueShield of South CarolinaAbout the role
Summary
Responsible for the accurate and timely processing of claims.
Description
Logistics:
- This is a full time (40 HPW) position, and our ideal candidate will work on-site at our Columbia, SC location.
- Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen.
- SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). To comply with the McNamara-O'Hara Service Contract Act (SCA), employees must enroll in our health insurance even if they have other health insurance. Employees will receive supplemental pay for health insurance until they are enrolled in our health insurance, first of the month following 28 days after the hire date.
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.
- 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
Our comprehensive benefits package includes the following:
We offer our employees great benefits and rewards. You will be eligible to participate in the benefits on 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
- Education Assistance
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 an opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
What to Except 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.
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