Processor, Claims I

Summary: Responsible for the accurate and timely processing of claims. Investigates and processes claims according to business regulations, 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 update patient identification, other health insurance, provider identification, and other files as necessary. This role requires ability to obtain a security clearance and is based on-site in Columbia, SC. What You’ll Do includes researching and processing claims, coding verification, defect resolution, and cross-department coordination. Qualifications emphasize high school education and strong analytical, communication, and math skills; healthcare/insurance experience is preferred.