Claims Auditor

Are you passionate about ensuring accuracy in medical claims? BlueCross BlueShield of South Carolina is currently seeking a Claims Auditor to join our team. In this role, you will be responsible for overseeing our medical claims process and ensuring accurate data entry and payment of claims. We are looking for a detail-oriented, organized professional with exceptional communication skills to join our team. If this sounds like you, then we want to hear from you!To be considered for this role, you must possess a minimum of three years of experience in a professional environment, preferably in a medical claims or accounting role. You should also have a working knowledge of medical and insurance terminology, as well as a strong understanding of insurance coding and billing procedures. Additionally, we are looking for someone who is highly motivated, has excellent problem-solving skills, and is able to work independently.

Responsibilities:

1. Oversee the medical claims process and ensure accurate data entry and payment of claims.
2. Review medical claims for accuracy and completeness.
3. Monitor and audit claims to ensure compliance with applicable rules, regulations, and policies.
4. Investigate discrepancies in claims and resolve any issues.
5. Communicate with providers, carriers, and other stakeholders to ensure timely and accurate processing of claims.
6. Stay up to date on changes in medical coding and billing procedures.
7. Maintain accurate records of claims and payments.
8. Develop and implement strategies to ensure accuracy in claims processing.
9. Provide training and guidance to staff on medical claims processes.
10. Prepare and present reports on claims and payment activities.

According to JobzMall, the average salary range for a Claims Auditor in Greenville, SC, USA is $46,000-$71,000 per year. The salary range can vary depending on factors such as the employer, the individual's experience, and the type of industry the individual works in.

BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association. BlueCross serves 21.5 million people through private business and government contracts.