Claims Auditor

At BlueCross BlueShield of South Carolina, we are looking for an experienced Claims Auditor to join our team and help ensure accuracy in the processing of claims. The ideal candidate for this role is an individual with a keen eye for detail, excellent problem-solving abilities, and a commitment to ensuring accuracy and fairness in the claims process. If this sounds like you, then you may be the perfect fit for this position.To be successful in this role as Claims Auditor, you must have a minimum of five years experience in a claims processing role, along with an in-depth understanding of the claims process and applicable regulations. You must also possess strong communication and organizational skills and be comfortable working in a fast-paced environment. Knowledge of coding and medical terminology is preferred, but not required.If you are a detail-oriented professional with a commitment to excellence and accuracy, come join our team as Claims Auditor at BlueCross BlueShield of South Carolina.

Responsibilities:

1. Review claims documents for accuracy and completeness.
2. Ensure compliance with applicable regulations, policies, and procedures.
3. Investigate discrepancies and discrepancies in claims data.
4. Make recommendations to improve claims processing accuracy and efficiency.
5. Monitor and audit claims processing systems for accuracy and compliance.
6. Follow up with internal and external stakeholders to resolve outstanding claims.
7. Prepare reports and summaries on claims processing activities.
8. Collaborate with other departments to ensure accuracy and fairness in the claims process.
9. Train and mentor new claims processing staff.
10. Develop and maintain relationships with internal and external stakeholders.

According to JobzMall, the average salary range for a Claims Auditor in Lexington, SC, USA is $48,000-$67,000 per year. This range is dependent on the individual's experience, job title, and employer.

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.