South Carolina Claim Processor

Job Summary

To ensure accurate and timely insurance claim processing, the full-time South Carolina Claim Processor will resolve claim edits, manage denied claims, and utilize electronic billing systems while working remotely.

Key responsibilities

• Update patient account information and resolve authorization issues while ensuring compliance with payer rules
• Follow up on denied claims through communication with third-party payers and utilize payer websites for information gathering
• Maintain quality and productivity standards as set by management while keeping them informed of operational issues and trends

Required qualifications

• High School Diploma or equivalent
• 0-6 months of relevant work experience in medical billing or claims processing
• Familiarity with electronic billing systems and insurance claim procedures
• Ability to research and resolve claims effectively
• Knowledge of payer rules and changes