Claims Technician - PGBA (Part-Time)

PGBA – one of BlueCross BlueShield's South Carolina subsidiary companies

About the role

Performs routine but varied clerical duties in accordance with standard procedures. Maintains records, prepares forms, verifies information, and resolves routine problems. Ensures claims are processed in a timely manner.

Responsibilities

• Receives, opens, sorts, and distributes incoming departmental mail or work requests.
• Checks workflow documents to ensure required information is available; requests any missing documentation as needed.
• Scans all documents for storage in the electronic repository.
• Prepares correspondence or packages for internal/external mailing.
• Screens and verifies information to ensure proper and accurate processing flow of all paper claims and correspondence in accordance with department standards for quality and production, contract regulations, policies, and guidelines.
• Conducts data element verification for those that fail the mapping process prior to claims adjudication.
• Applies appropriate indexes as needed to claims and/or correspondence.
• Maintains departmental logs, spreadsheets, or databases.
• Effectively uses all available reference materials in performance of daily functions.
• Keeps track of supply inventory and/or orders supplies as needed.

Requirements

• High School Diploma or equivalent.
• Strong organizational and analytical skills.
• Good communication and organizational skills.
• Detail-oriented.
• Ability to handle confidential or sensitive information with discretion.
• Ability to obtain a security clearance, which requires applicants to be a U.S. Citizen.

Preferred Skills

• Ability to accurately key 5000 ksph or 30 wpm.
• Knowledgeable in word processing and spreadsheet applications.

Schedule

This position is part-time (20 hours/week) Monday–Friday from 8:00 AM–12:00 PM in a typical office environment. This role is located on-site at 2141 W Gate Place, Florence, SC 29501.

Benefits

You will be eligible to participate in the benefits for the first of the month following 28 days of employment.

• Subsidized health plans, dental, and vision coverage.
• 401k retirement savings plan with company match.
• Life Insurance.
• Paid Time Off (PTO).
• On-site cafeterias and fitness centers in major locations.
• Education Assistance.
• Service Recognition.
• National discounts to movies, theaters, zoos, theme parks, and more.

Under the McNamara-O'Hara Service Contract Act (SCA), employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date.