Claims Processor I

Claims Processor Ito be responsible for the accurate and timely processing of claims. Support the overall quality effectiveness to ensure that all claims are processed accurately and complete to ensure appropriate adjustment code usage, and payment rate.

Schedule: Monday-Friday, 8:00 AM-5:00 PM

Location: 8733 Highway 17 Bypass, Myrtle Beach, SC 29575

Pay:Weekly pay

Research and processes claims according to business regulation, internal standards and processing guidelines.

Verifies the coding of procedure and diagnosis codes.

Resolve 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.

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. Proficient in word processing and spreadsheet applications. Proficient in database software.

Required Education:

High School Diploma or equivalent

Required Work Experience:

1 year-of experience in a healthcare or insurance environment.

Preferred Skills and Abilities:

Ability to use complex mathematical calculations.