Processor, Claims II jobs in United States
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Facebook · 10 hours ago

Processor, Claims II

BlueCross BlueShield of South Carolina is a subsidiary of BlueCross BlueShield, and they are seeking a Processor, Claims II. This role involves reviewing and adjudicating complex or specialty claims while ensuring compliance with organizational policies and assisting in training new staff members.

Computer Software
badNo H1BnoteSecurity Clearance RequirednoteU.S. Citizen Onlynote

Responsibilities

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
Research 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

Qualification

Claims processingAnalytical skillsMicrosoft OfficeBusiness mathCommunication skillsWord processingSpreadsheet applicationsDatabase softwareOrganizational skillsTime managementConfidentiality

Required

High School Diploma or equivalent
2 years of experience processing, researching and adjudicating claims
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
Microsoft Office

Preferred

2 years of claims processing experience
Strong time management skills
Knowledge of mathematical and statistical concepts
Proficient in word processing and spreadsheet applications
Proficient database software skills

Benefits

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
Education Assistance
Service Recognition
National discounts to movies, theaters, zoos, theme parks and more

Company

Facebook

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The Facebook company is now Meta. Meta builds technologies that help people connect, find communities, and grow businesses.

Funding

Current Stage
Late Stage

Leadership Team

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Arunava Chatterjee
Executive Director of Ghost Black Operations & CEO & CTO
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Shubhra Gupta
CEO
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Company data provided by crunchbase