Claims Processor I
BlueCross BlueShield of South Carolina, Columbia, SC, United States
Summary
Responsible for the accurate and timely processing of claims.
Description
Logistics:
PGBA
– one of BlueCross BlueShield's South Carolina subsidiary companies.
Location
This position is full-time (40 hours/week) Monday‑Friday from 8:00 am‑5:00 pm in a typical office environment. The role is located on‑site at 17 Technology Cir, Columbia, SC 29203.
Other Information
Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. citizen.
SCA Benefit Requirements: Employees must enroll in BlueCross BlueShield of South Carolina health insurance even if they have other coverage. Supplemental pay for health insurance is provided until enrollment, effective the 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. Verify the coding of procedure and diagnosis codes.
Resolve system edits, audits, and claims errors through research and use of approved references and investigative sources.
Coordinate with internal departments to work edits and deferrals, updating 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.
Basic business math skills.
Required Software and Tools: Basic office equipment.
We Prefer That You Have The Following
Preferred Skills and Abilities: Ability to use complex mathematical calculations.
Preferred Software and Other Tools: Proficiency in word processing and spreadsheet applications; proficiency in database software.
Benefits
Subsidized health plans, dental and vision coverage.
401(k) 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.
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 the opportunity to develop their skills, advance their careers, and contribute their unique abilities to the growth of our company.
What To Expect Next
After submitting your application, our recruiting team will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication to verify resume specifics and salary expectations.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote 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. As a federal contractor, the company maintains affirmative action programs to promote opportunities for individuals with disabilities and protected veterans. We provide equal opportunities in all phases of the employment process and comply with applicable federal, state, and local laws and regulations.
We are committed to providing reasonable accommodations to individuals with disabilities, pregnant individuals, and individuals with pregnancy‑related conditions or sincerely held religious beliefs, provided such accommodations do not impose an undue hardship on the company.
If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 800‑288‑2227, ext. 47480 with the nature of your request. We will determine the request on a case‑by‑case basis.
We participate in E‑Verify and comply with Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.
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Responsible for the accurate and timely processing of claims.
Description
Logistics:
PGBA
– one of BlueCross BlueShield's South Carolina subsidiary companies.
Location
This position is full-time (40 hours/week) Monday‑Friday from 8:00 am‑5:00 pm in a typical office environment. The role is located on‑site at 17 Technology Cir, Columbia, SC 29203.
Other Information
Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. citizen.
SCA Benefit Requirements: Employees must enroll in BlueCross BlueShield of South Carolina health insurance even if they have other coverage. Supplemental pay for health insurance is provided until enrollment, effective the 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. Verify the coding of procedure and diagnosis codes.
Resolve system edits, audits, and claims errors through research and use of approved references and investigative sources.
Coordinate with internal departments to work edits and deferrals, updating 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.
Basic business math skills.
Required Software and Tools: Basic office equipment.
We Prefer That You Have The Following
Preferred Skills and Abilities: Ability to use complex mathematical calculations.
Preferred Software and Other Tools: Proficiency in word processing and spreadsheet applications; proficiency in database software.
Benefits
Subsidized health plans, dental and vision coverage.
401(k) 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.
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 the opportunity to develop their skills, advance their careers, and contribute their unique abilities to the growth of our company.
What To Expect Next
After submitting your application, our recruiting team will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication to verify resume specifics and salary expectations.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote 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. As a federal contractor, the company maintains affirmative action programs to promote opportunities for individuals with disabilities and protected veterans. We provide equal opportunities in all phases of the employment process and comply with applicable federal, state, and local laws and regulations.
We are committed to providing reasonable accommodations to individuals with disabilities, pregnant individuals, and individuals with pregnancy‑related conditions or sincerely held religious beliefs, provided such accommodations do not impose an undue hardship on the company.
If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 800‑288‑2227, ext. 47480 with the nature of your request. We will determine the request on a case‑by‑case basis.
We participate in E‑Verify and comply with Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.
#J-18808-Ljbffr