Processor, Claims I

Summary Responsible for the accurate and timely processing of claims. Logistics: PGBA – one of BlueCross BlueShield's South Carolina subsidiary companies. Location This position is full-time (40‑hours/week), Monday‑Friday from 8‑5pm in a typical office environment on‑site at 8733 Highway 17 Bypass, Myrtle Beach, SC 29575. Government Clearance This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. Responsibilities 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 patient identification, other health insurance, provider identification and other files as necessary. Required Qualifications 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. Basic office equipment proficiency. Preferred Qualifications 1 year of experience in a healthcare or insurance environment. Ability to use complex mathematical calculations. 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. Employees become eligible to participate in the benefits the first month following 28 days of employment. SCA compliance: employees must enroll in company health insurance; supplemental pay provided until enrollment. 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, 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 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, individuals with pregnancy‑related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that such accommodations do not impose undue hardship on the company. For assistance with accommodations, please email View email address on click.appcast.io or call View phone number on click.appcast.io. #J-18808-Ljbffr