Claims Adjuster

Remote Full-time
At BlueCross BlueShield of South Carolina, we are looking for a Claims Adjuster who is passionate about providing excellent customer service. The successful candidate for this role will have a strong background in claims and insurance, excellent communication skills, and an attention to detail that ensures customers receive accurate and timely claims adjustments. Our ideal candidate will be organized, have a strong work ethic, and have a customer service-oriented mindset. If you are an experienced Claims Adjuster looking to make an impact, we would love to hear from you. Qualifications:• Bachelor’s degree in Business Administration, Insurance, or related field preferred• Relevant claims and insurance experience• Knowledge of medical terminology• Excellent verbal and written communication skills• Ability to work in a fast-paced environment• Outstanding organizational skills• Skilled in problem-solving and customer service• Familiarity with BlueCross BlueShield policies and procedures

Responsibilities:

• Review and process claims in an efficient and accurate manner, ensuring that all claims meet BlueCross BlueShield regulations and requirements.

• Respond promptly and effectively to customer inquiries and complaints, and provide timely resolutions.

• Utilize knowledge of medical terminology when verifying claims and resolving customer issues.

• Investigate potential fraudulent claims and provide appropriate documentation.

• Monitor and update claims databases to ensure accuracy of information.

• Work with other departments to ensure customer satisfaction.

• Maintain up-to-date knowledge of BlueCross BlueShield policies and procedures.

• Work with other Claims Adjusters to ensure that claims are processed in a timely manner.

• Provide accurate and timely reporting to management.

BlueCross BlueShield of South Carolina is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.

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