Claims Processor I

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<span><span><span><span><span><span><span><span><h1><br><span><span><span><u><b>Summary</b></u></span></span></span><br> </h1></span></span></span></span></span></span></span></span>Responsible for the accurate and timely processing of claims.<span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><h1><br><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><b><u>Description</u></b></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br> </h1></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><p><b><span>Location: </span></b><span>This position is full-time (40-hours/week) Monday-Friday from 8am-5pm and fully remote. The candidate may be asked to come on-site for training, meetings, or other business needs.</span></p><p></p><p><b><span>What You’ll Do: </span></b></p><ul><li><p>Researches and processes claims according to business regulation, internal standards and processing guidelines. Verifies the coding of procedure and diagnosis codes.</p></li><li><p>Resolves system edits, audits and claims errors through research and use of approved references and investigative sources.</p></li><li><p>Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.</p></li></ul><p></p><p><b><span>To Qualify for This Position, You'll Need the Following: </span></b></p><ul><li><p><b><span>Required Education: </span></b>High School Diploma or equivalent</p></li><li><p><b><span>Required Skills and Abilities:</span></b></p></li><li><p>Strong analytical, organizational and customer service skills.</p></li><li><p>Strong oral and written communication skills.</p></li><li><p>Proficient spelling, punctuation and grammar skills.</p></li><li><p>Good judgment skills.</p></li><li><p>Basic business math skills</p></li><li><p><b><span>Required Software and Tools: </span></b>Basic office equipment.</p></li></ul><p></p><p><b><span>We Prefer That You Have the Following:</span></b></p><ul><li><p><b><span>Preferred Work Experience: </span></b><span>1 year-of experience in a healthcare or insurance environment.</span></p></li><li><p><b><span>Preferred Skills and Abilities: </span></b><span>Ability to use complex mathematical calculations.</span></p></li><li><p><b><span>Preferred Software and Other Tools: </span></b><span>Proficient in word processing and spreadsheet applications. Proficient in database software.</span></p></li></ul><p></p><p><b><span>Our Comprehensive Benefits Package Includes the Following:</span></b></p><p>We offer our employees great benefits and rewards.  You will be eligible to participate in the benefits for the first of the month following 28 days of <span><span style="overflow-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">employment.  </span></span></p><ul><li><p>Subsidized health plans, dental and vision coverage</p></li><li><p>401k retirement savings plan with company match</p></li><li><p>Life Insurance</p></li><li><p>Paid Time Off (PTO)</p></li><li><p>On-site cafeterias and fitness centers in major locations</p></li><li><p>Education Assistance</p></li><li><p>Service Recognition</p></li><li><p>National discounts to movies, theaters, zoos, theme parks and more</p></li></ul><p></p><p><b><span>What We Can Do for You: </span></b></p><p>We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.</p><p></p><p><b><span>What To Expect Next: </span></b></p><p>After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.</p><p></p><p></p><p></p><p></p><p><b><span><span><span><span><span><span><span><span><span><span><span><span><span><span>Equal Employment Opportunity Statement</span></span></span></span></span></span></span></span></span></span></span></span></span></span></b></p><p></p><p>BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with <span style="overflow-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">disabilities and</span> protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.</p><p></p><p>We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.</p><p></p><p>If you need special assistance or an accommodation while seeking employment, please email <a href="mailto:mycareer.help@bcbssc.com" target="_blank" rel="noopener noreferrer"><span style="overflow-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">mycareer.help@bcbssc.com</span></a> or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.</p><p></p><p>We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's <a href="https://www.southcarolinablues.com/web/public/resources/c4cb28a0-f717-4f26-8270-abae70243be7/Everify_EEO+2019.pdf?MOD=AJPERES&CVID=mKvY6R0" target="_blank" rel="noopener noreferrer"><span style="overflow-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">more information</span></a><a href="https://www.southcarolinablues.com/web/public/resources/c4cb28a0-f717-4f26-8270-abae70243be7/Everify_EEO+2019.pdf?MOD=AJPERES&CVID=mKvY6R0" target="_blank" rel="noopener noreferrer">.</a></p><p></p><p>Some states have required notifications. Here's <a href="https://www.southcarolinablues.com/web/public/resources/cf014797-0b05-46c2-ab33-ec3a1bf9864a/California+Notice+to+Applicants_.pdf?MOD=AJPERES&CVID=oJErh8p" target="_blank" rel="noopener noreferrer">more information</a>. </p>

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About United Kingdom

The United Kingdom is an island nation located on the northwest coast of Europe. The United Kingdom includes the entire island of Great Britain, which includes England, Wales, and Scotland, as well as the northern part of the island of Ireland. The name Great Britain is sometimes used to refer to the United Kingdom as a whole. The capital is London, which is one of the business, financial, and cultural centers of the world. Other major cities are Birmingham, Liverpool, and Manchester in England, Belfast and Londonderry in Northern Ireland, Edinburgh and Glasgow in Scotland, and Swansea and Cardiff in Wales.

Common Interview Questions

  • Tell me about yourself.
  • Walk me through your resume.
  • How did you hear about this position?
  • Why do you want to work at this company?
  • Why do you want this job?
  • Why should we hire you?
  • What can you bring to the company?
  • What are your greatest strengths?
  • What do you consider to be your weaknesses?
  • What is your greatest professional achievement?
  • Tell me about a challenge or conflict you’ve faced at work, and how you dealt with it.
  • Tell me about a time you demonstrated leadership skills.
  • What’s a time you disagreed with a decision that was made at work?
  • Tell me about a time you made a mistake.
  • Tell me about a time you failed.
  • Why are you leaving your current job?
  • Why were you fired?
  • Why was there a gap in your employment?
  • Can you explain why you changed career paths?
  • What’s your current salary?
  • What do you like least about your job?
  • What are you looking for in a new position?
  • What type of work environment do you prefer?
  • What’s your work style?
  • What’s your management style?
  • How would your boss and coworkers describe you?
  • How do you deal with pressure or stressful situations?
  • What do you like to do outside of work?
  • Are you planning on having children?
  • How do you stay organized?
  • How do you prioritize your work?
  • What are you passionate about?
  • What motivates you?
  • What are your pet peeves?
  • How do you like to be managed?
  • Do you consider yourself successful?
  • Where do you see yourself in five years?
  • How do you plan to achieve your career goals?
  • What are your career aspirations?
  • What’s your dream job?
  • What other companies are you interviewing with?
  • What makes you unique?
  • What should I know that’s not on your resume?
  • What would your first few months look like in this role?
  • What are your salary expectations?
  • What do you think we could do better or differently?
  • When can you start?
  • Are you willing to relocate?
  • How many tennis balls can you fit into a limousine?
  • If you were an animal, which one would you want to be?
  • Sell me this pen.
  • Is there anything else you’d like us to know?
  • Do you have any questions for us?

Educational Qualification

Candidates Who Have Passed Graduate or its Equivalent from a Recognized Board or University Are Eligible For this recruitment. Kindly check the Official Notification for more qualification details. Notification Link Is Given Below.

Document Required

Required Documents for This recruitment: Candidate should have these documents before applying online. Candidates are suggested to read the official notification before applying.

  • Qualification certificate with mark sheets.
  • Passport size photographs.
  • Signature.

How to Apply

All the eligible candidates can apply for this job as mentioned below:

  • Read official notification carefully from the official website.
  • Read notification carefully before applying.
  • Fill the application form (link is given below).
  • Attach required documents and passport size photo with signature.
  • Then submit. Done.

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