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Claims Processor I, Part Time
BlueCross BlueShield of South Carolina. Research and process claims according to business regulations, internal standards, and processing guidelines .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates strong analytical and organizational skills while processing claims in accordance with business regulations and internal standards. Proficient in communication and customer service, with the ability to resolve claims errors and coordinate effectively with internal departments.
Highest-signal resume keywords
Claims ProcessingAnalytical SkillsCustomer ServiceCommunication SkillsDatabase Software
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims ResearchProcedure CodingDiagnosis CodingMathematical CalculationsOffice Equipment ProficiencyWord ProcessingSpreadsheet Applications
Soft Skills
Organizational SkillsGood JudgmentOral CommunicationWritten Communication
Certifications & Qualifications
High School Diploma
Industry Keywords
Healthcare EnvironmentInsurance Environment
About the role
Key responsibilities & impact- Research and process claims according to business regulations, internal standards, and processing guidelines
- Verify coding of procedure and diagnosis codes
- Resolve system edits, audits, and claims errors through research and approved references and investigative sources
- Coordinate with internal departments to work edits and deferrals
- Update patient identification, other health insurance, provider identification, and other files as necessary
- Complete approximately 8-10 weeks of onsite training, Monday-Friday, 8:00 AM-4:30 PM
Requirements
What you’ll need- 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
- Preferred: 1 year of experience in a healthcare or insurance environment
- Preferred: Ability to use complex mathematical calculations
- Preferred: Proficient in word processing and spreadsheet applications
- Preferred: Proficient in database software
- Must work Monday through Friday during the scheduled part-time shift within 8:00 AM - 5:00 PM normal business hours
- Sponsorship is not eligible now or in the future
- Travel required; may be required to travel between buildings
Benefits
Comp & perks- Subsidized health plans, dental and vision coverage
- 401K retirement savings plan with company match
- Life Insurance
- Paid Time Off (PTO)
- On-site cafeterias and fitness centers in major locations
- Wellness program and healthy lifestyle premium discount
- Tuition assistance
- Service recognition
- Employee Assistance
- Discounts on movies, theaters, zoos, theme parks and more
- Opportunity to develop skills, advance careers and contribute to company growth