Please APPLY using link at bottom of page.
We are currently hiring for a Claims Processor II to join BlueCross BlueShield of South Carolina. In this role as Claims Processor II you will review and adjudicate complex or specialty claims. You will also determine whether to return, deny or pay claims following organizational policies and procedures and assist in training or mentoring new staff members.
Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we have been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation’s leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are committed to the same philosophy, consider joining our team!
Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.
Logistics
This position is full time (40 hours/week) Monday-Friday 8:00-5:00 at 8733 Highway 17 Bypass Myrtle beach, SC 29575 location.
What You Will Do:
- Examines and processes complex or specialty claims according to business/contract regulations, internal standards and examining guidelines. Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes. Verifies that claims have been keyed correctly.
- Ensures that claims are processing according to established quality and production standards. Corrects processing errors by reprocessing, adjusting, and/or recouping claims.
- Researches and resolves claims edits and deferrals. Performs research on claim problems by utilizing policies, procedures, reference materials, forms and coordinates with various internal support areas. Responds to routine correspondence and completes spreadsheet if applicable.
To Qualify for This Position, You Will Need:
- Required Education: High School Diploma or equivalent.
- Required Work Experience: 2 years of experience processing, researching and adjudicating claims.
- Required Skills and Abilities: Strong organizational, analytical and judgment skills. Strong oral and written communication skills. Proficient in spelling, punctuation and grammar. Proficient in basic business math. Ability to handle confidential or sensitive information with discretion.
- Required Software and Tools: Microsoft Office.
What We Prefer:
- 5 years-of experience processing and adjudicating claims.
- Strong time management skills.
- Knowledge of mathematical and statistical concepts.
- Proficient in word processing and spreadsheet applications.
What We Can Do for You:
- 401(k) retirement savings plan with company match.
- Subsidized health plans and free vision coverage.
- Life insurance.
- Paid annual leave – the longer you work here, the more you earn.
- Nine paid holidays.
- On-site cafeterias and fitness centers in major locations.
- Wellness programs and healthy lifestyle premium discount.
- Tuition assistance.
- Service recognition.
- Incentive Plan.
- Merit Plan.
- Continuing education funds for additional certifications and certification renewal.
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 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
APPLY HERE : https://ourhrconnect.wd5.myworkdayjobs.com/SCBlues/job/Myrtle-Beach-South-Carolina/Claims-Processor-II_R1040259-1
Job Type: Full-time
Pay: $17.20 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
- Holidays
- Monday to Friday
Education:
- High school or equivalent (Required)
Experience:
- Microsoft Office: 1 year (Required)
- claims: 1 year (Preferred)
Ability to Relocate:
- Myrtle Beach, SC 29575: Relocate before starting work (Required)
Work Location: In person
