Claims Auditor

BlueCross BlueShield of South Carolina is looking for an experienced Claims Auditor to join our highly-regarded team. This is your chance to work for an industry leader while ensuring that our company is adhering to legal regulations and standards. As a Claims Auditor, you will need to have a strong attention to detail, excellent research skills, and a commitment to delivering accurate results. The ideal candidate will have a degree in accounting or a similar field and a minimum of three years' experience in the insurance industry. If you are seeking an opportunity to make an impact and have a passion for process improvement and compliance, this is the job for you.

Responsibilities:

1. Review claims data to ensure that the company is compliant with all applicable legal regulations and standards.
2. Maintain records of audited claims, including any discrepancies or errors.
3. Utilize research skills to identify any issues related to the accuracy of claims and provide recommendations for improvement.
4. Analyze trends and patterns in claims data to identify areas of improvement and cost savings.
5. Prepare reports and presentations to summarize findings and provide recommendations for process improvement.
6. Keep abreast of new and changing laws, regulations, and standards that may affect the company’s claims processes.
7. Collaborate with other departments to ensure that the company’s claims processes are efficient and effective.
8. Monitor and audit claims for accuracy and timeliness of payments.
9. Maintain strong relationships with insurance providers and other stakeholders.
10. Provide training and guidance to new auditors.

According to JobzMall, the average salary range for a Claims Auditor in Columbia, SC, USA is $40,000 to $80,000 per year. This range can vary depending on experience and qualifications.

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.