Claims Processor - South Carolina

Job Summary

Determining covered medical insurance benefits, the full-time Claims Processor - South Carolina will document medical claims processes, resolve claims by approving or denying them, and ensure compliance with legal and company policies while working remotely.

Key responsibilities

• Document medical claims processes by completing necessary forms, reports, and logs
• Resolve medical claims by approving or denying them, calculating benefits due, and initiating payments
• Ensure compliance with company policies and federal insurance regulations while resolving claims and edits

Required qualifications

• High School Degree or Equivalent
• 0-6 months of relevant work experience
• Familiarity with medical claims processes and insurance benefits
• Ability to access and verify insurance information through applicable systems
• Understanding of federal insurance regulations and compliance guidelines