ClaimsProcessorI-32

# _**Summary**_ Responsible for the accurate and timely processing of claims. # **_Description_** **Logistics:**[**PGBA**](https://pgba.com/) **– one of BlueCross BlueShield 's South Carolina subsidiary companies.** **Location:** This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role is located on-site at 200 N Dozier Blvd, Florence, SC 29501. * **SCA Benefit Requirements:** BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act _(_ SCA _)._**To comply with the McNamara-O 'Hara Service Contract Act (SCA), employees must enroll in our health insurance even if they have other health insurance. Employees will receive supplemental pay for health insurance until they are enrolled in our health insurance, first of the month following 28 days after the hire date.** **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. **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 skills. * 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