Claims Auditor

We at BlueCross BlueShield of South Carolina are looking for a Claims Auditor to join our team and help ensure the accuracy of our medical claims. This is an exciting opportunity to make a real difference in the lives of our members. The ideal candidate for this position is a highly organized, detail-oriented individual with a passion for accuracy and an aptitude for problem solving. The Claims Auditor will be responsible for reviewing and analyzing medical claims to ensure accuracy and compliance with all pertinent regulations. The successful candidate will have the ability to interpret and apply claims payment policies and regulations to ensure accuracy and completeness of all claims.Required Qualifications:• Bachelor’s degree in Business, Healthcare Administration, or related field• 2+ years of experience in claims processing, auditing, or related field• Knowledge of medical terminology• Knowledge of insurance regulations and requirements• Proficiency in Microsoft Office (Word, Excel, Access, Outlook)• Excellent written and verbal communication skills• Ability to work independently and as part of a team• Ability to maintain confidentiality of sensitive information

Responsibilities: • Review and analyze medical claims for accuracy and compliance with all relevant regulations • Interpret and apply claims payment policies and regulations • Ensure accuracy and completeness of all claims • Research and resolve complex claims issues • Identify process improvements and recommend solutions • Prepare reports summarizing findings • Maintain documentation of auditing process • Participate in audits as needed • Maintain confidentiality of sensitive information • Identify and report any fraudulent activity • Provide training and support to staff as needed • Communicate regularly and effectively with internal and external partners

According to JobzMall, the average salary range for a Claims Auditor in Rock Hill, SC, USA is between $60,000 and $72,000 per year. This range is based on the salaries reported by employers who are actively hiring in the area.

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.