Claims Processor I

Overview Responsible for the accurate and timely processing of claims for BlueCross BlueShield’s South Carolina subsidiary, PGBA. This is a full‑time 40‑hour work week, Monday through Friday, 8:00am to 5:00pm in a typical office environment. The office is located at 8733 Highway 17 Bypass, Myrtle Beach, SC 29575. Location and Security Clearance This position requires the ability to obtain a security clearance; applicants must be U.S. citizens. Because the company is a federal contractor, employees must enroll in the company health insurance within 28 days of hire to receive supplemental pay. Responsibilities Research and process claims according to business regulation, internal standards, and processing guidelines. Verify the coding of procedures and diagnosis codes. Resolve system edits, audits, and claim errors through research and use of approved references. Coordinate 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 with proficient spelling, punctuation, and grammar. Good judgment and basic business math skills. Basic office equipment and software proficiency. Preferred Qualifications One year of experience in a healthcare or insurance environment. Ability to use complex mathematical calculations. Proficiency in word processing, spreadsheet, and database applications. 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. Equal Employment Opportunity Statement BlueCross BlueShield of South Carolina and its 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. Reasonable Accommodations We are committed to working with and 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 an undue hardship on the company. If you need special assistance or an accommodation while seeking employment, please email View email address on click.appcast.io or call View phone number on click.appcast.io with the nature of your request. A determination will be made on a case‑by‑case basis. #J-18808-Ljbffr PVH (Tommy Hilfiger/Calvin Klein)