Claims Processor I Part Time

Position Purpose

Responsible for the accurate and timely processing of claims.

Key Responsibilities

• Research and process claims according to business regulation, internal standards, and processing guidelines.
• Verify the coding of procedure and diagnosis codes.
• Resolve system edits, audits, and claims errors through research and use of approved references and investigative sources.
• Coordinate with internal departments to work edits and deferrals.
• Update patient identification, other health insurance, provider identification, and other files as necessary.

Requirements & Tech Stack

• High School Diploma or equivalent.
• Basic Office Equipment.

Qualifications

• 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.

Preferred Experience

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

Preferred Skills & Tools

• Ability to use complex mathematical calculations.
• Proficient in word processing and spreadsheet applications.
• Proficient in database software.

Work Schedule & Location

• This position is part-time (30 hours/week).
• Schedule: Monday through Friday, during normal business hours (8:00 AM - 5:00 PM).
• May require occasional overtime.
• May be required to travel between buildings.
• Location: On-site at 4101 Percival Road, Columbia, SC.
• Training: On-site, Monday-Friday, 8:00 AM - 4:30 PM for approximately 8-10 weeks.
• Eligibility for Work-at-Home (W@H) after performance review, training completion, equipment issuance, and review of LOB business needs.