Claims Auditor

At BlueCross BlueShield of South Carolina, we are looking for an experienced Claims Auditor to join our team. The ideal candidate will have a strong background in insurance claims processing, with an exceptional eye for detail and a commitment to upholding the highest standards of accuracy and integrity. To be successful in this role, you will need to have excellent organizational skills, the ability to work independently, and the ability to interact effectively with all levels of staff and management. If you are a proactive and reliable individual who is passionate about delivering exceptional customer service, we want to hear from you.Required Qualifications:• Bachelor’s degree in Business Administration, Accounting or a related field• At least 3 years of experience in claims processing, auditing, or related experience• Knowledge of insurance claims processing and auditing procedures• Proficient in Microsoft Office (Word, Excel, PowerPoint, etc.)• Excellent analytical, organizational, and problem-solving skills• Strong written and verbal communication skills• Ability to work independently and meet deadlines• Highly organized and detail-oriented• Ability to work with confidential information in a professional manner

Responsibilities:

• Develop and implement audit plans for all claims processing within the organization

• Ensure accuracy and integrity of all claims processing, including review of claim forms, coding, and payment processes

• Review claims processing documents and recommend improvements and corrective actions

• Monitor claims processing activities and identify discrepancies

• Develop and maintain positive working relationships with staff and management

• Evaluate and analyze claims data and metrics to identify trends and patterns

• Prepare detailed audit reports and make recommendations for process improvements and corrective actions

• Stay up to date with changes in insurance industry regulations and best practices

• Analyze claims processing operations to ensure compliance with regulations and company policies

• Research and resolve customer inquiries and complaints regarding claims processing

• Maintain confidentiality of all client information and records

According to JobzMall, the average salary range for a Claims Auditor in Charleston, SC, USA is between $46,547 and $76,622 per year. The salary range varies based on the experience and qualifications of the auditor. Additional benefits such as bonuses, health insurance, and vacation pay may also be included in the salary package.

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.