South Carolina Licensed Claims Processor

Job Summary

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

Key responsibilities

• Determine covered medical insurance benefits according to plan documents
• Document medical claims processes by completing necessary forms and reports
• Resolve medical claims by calculating benefits due and initiating payments or denials

Required qualifications

• High School Degree or equivalent
• 0-6 months of relevant work experience
• Understanding of medical insurance policies and regulations
• Ability to follow company policies and federal guidelines