Summary
Responsible for the accurate and timely processing of claims.
Description
Logistics:
Position will work from Florence, SC office. Potential to work from home once training is completed and production standards are met. Usually takes six months to one year before work at home potential is available.
What You'll Do
Researches 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.
Required Education
High School Diploma or equivalent
Required Work Experience
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.
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.
Work Environment
Typical office or home environment.
What Blue Can Do For You
Our comprehensive benefits package includes:
- Nine paid holidays
- Life insurance
- 401(k) retirement savings plan with company match
- On-site cafeterias and fitness centers in major locations
- Subsidized health plans and free vision coverage
- Wellness programs and a healthy lifestyle premium discount
- Tuition assistance
- Service recognition
- Paid annual leave — the longer you work here, the more you earn
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 our 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.
Researches 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.
Our Comprehensive Benefits Package Includes
- Paid annual leave — the longer you work here, the more you earn
- Service recognition
- Wellness programs and a healthy lifestyle premium discount
- On-site cafeterias and fitness centers in major locations
- Nine paid holidays
- Subsidized health plans and free vision coverage
- 401(k) retirement savings plan with company match
- Life insurance
- Tuition assistance
- 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 our 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.
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. 43172 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
