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BlueCross BlueShield of South Carolina
Claims Processor II (Nashville, TN)BlueCross BlueShield of South Carolina • Nashville, Tennessee
Claims Processor II (Nashville, TN)

Claims Processor II (Nashville, TN)

BlueCross BlueShield of South Carolina • Nashville, Tennessee
30+ days ago
Job type
  • Full-time
Job description

Description


Logistics

This position is full time (40 hours/week) Monday-Friday 6:00am-5:30pm CST and will be on-site at One Century Plaza in Nashville, TN .

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:

  • 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.

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.
  • Proficient database software skills.

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.
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Claims Processor II (Nashville, TN) • Nashville, Tennessee

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