Claims Auditor

We are looking for an experienced Claims Auditor to join our team at BlueCross BlueShield of South Carolina. In this role, you will ensure the accuracy of claims processing and payments while meeting company standards of quality. You will be responsible for reviewing and analyzing claims data and preparing audit reports for management. The ideal candidate will have a strong attention to detail, excellent organizational skills, and the ability to multitask.The successful candidate must have at least a high school diploma or equivalent, plus two years of professional experience in claims auditing or related field. Knowledge of healthcare industry standards and regulations, as well as proficiency with Microsoft Office Suite, is also required. We are looking for a self-starter who is interested in furthering their career with our organization. If this opportunity excites you, we invite you to join our team and help us continue to provide quality care to our members.

Responsibilities:

1. Review and analyze claims data to ensure accuracy of payment and processing.
2. Prepare audit reports for management on a regular basis.
3. Monitor compliance with healthcare industry standards and regulations.
4. Investigate discrepancies or suspicious activity.
5. Provide recommendations to improve claims processing and payment accuracy.
6. Update policies and procedures as needed.
7. Ensure claims are registered, processed, and paid in a timely manner.
8. Identify and resolve any issues related to claims processing.
9. Collaborate with other departments to ensure efficient claims handling.
10. Maintain accurate and up-to-date records of all claims.

According to JobzMall, the average salary range for a Claims Auditor in Myrtle Beach, SC, USA is between $55,000 and $68,000 per year. The salary range may vary depending on the qualifications and experience of the individual.

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.