Pride Health is hiring a Pride Health is hiring a Specimen Technician to support our client's medical facility in Okatie SC 29909. This is a 5 months+ assignment with the possibility of a contract-to-hire opportunity, and it's a great way to start working with a top-tier healthcare organization!
Job Title: Specimen Technician
Location: Okatie SC 29909
Pay Range: $17.20 per hour
Schedule: M-F 9A-5P (40 hours per week)
Duration: 5 months+
Responsibilities:
Perform specimen processing tasks including A-station, presort, pickup, delivery, imaging, centrifugation, and aliquoting.
Enter data accurately and efficiently (6,000 keystrokes/hour).
Ensure accuracy, timeliness, and compliance with test regulations.
Maintain specimen organization and handle various specimen types correctly.
Adhere to safety protocols in a biohazard environment.
Meet productivity and quality standards in a production setting.
Communicate effectively with team members and other departments.
Keep work area clean and organized.
Demonstrate flexibility with shifts, weekends, holidays, and overtime.
Education/Qualifications:
High School Diploma or GED.
Prior laboratory experience preferred
Pride Global offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, , legal support, auto ,home insurance, pet insurance, and employee discounts with preferred vendors.
$17.2 hourly 2d ago
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Claims Processor I
PGBA 4.2
Claim processor job in Columbia, SC
Responsible for the accurate and timely processing of claims.
Logistics: PGBA - one of BlueCross BlueShield's South Carolina subsidiary companies
Location: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role is located on-site at 17 Technology Cir., Columbia, SC, 29203.
Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen.
What You'll Do:
Researches and processes claims according to business regulation, internal standards and processing guidelines. Verifies the coding of procedure and diagnosis codes.
Resolves system edits, audits and claims errors through research and use of approved references and investigative sources.
Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.
To Qualify for This Position, You'll Need the Following:
Required Education: High School Diploma or equivalent
Required Skills and Abilities:
Strong analytical, organizational and customer service skills.
Strong oral and written communication skills.
Proficient spelling, punctuation and grammar skills.
Good judgment skills.
Basic business math skills.
Required Software and Tools: Basic office equipment.
We Prefer That You Have the Following:
Preferred Work Experience: 1 year-of experience in a healthcare or insurance environment.
Preferred Skills and Abilities: Ability to use complex mathematical calculations.
Preferred Software and Other Tools: Proficient in word processing and spreadsheet applications. Proficient in database software.
Our Comprehensive Benefits Package Includes the Following:
We offer our employees great benefits and rewards. You will be eligible to participate in the benefits for the first of the month following 28 days of employment.
Subsidized health plans, dental and vision coverage
401k retirement savings plan with company match
Life Insurance
Paid Time Off (PTO)
On-site cafeterias and fitness centers in major locations
Education Assistance
Service Recognition
National discounts to movies, theaters, zoos, theme parks and more
What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
What To Expect Next:
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.
We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.
If you need special assistance or an accommodation while seeking employment, please email ************************ or call ************, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information.
Some states have required notifications. Here's more information.
$27k-41k yearly est. Auto-Apply 35d ago
Claims Examiner
Harris 4.4
Claim processor job in South Carolina
Responsibilities & Duties:Claims Processing and Assessment:
Evaluate incoming claims to determine eligibility, coverage, and validity.
Conduct thorough investigations, including reviewing medical records and other relevant documentation.
Analyze policy provisions and contractual agreements to assess claim validity.
Utilize claims management systems to document findings and process claims efficiently.
Communication and Customer Service:
Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements.
Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process.
Address customer concerns and escalate complex issues to senior claims personnel or management as needed.
Compliance and Documentation:
Ensure compliance with company policies, procedures, and regulatory requirements.
Maintain accurate records and documentation related to claims activities.
Follow established guidelines for claims adjudication and payment authorization.
Quality Assurance and Improvement:
Identify opportunities for process improvement and efficiency within the claims department.
Participate in quality assurance initiatives to uphold service standards and improve claim handling practices.
Collaborate with team members and management to implement best practices and enhance overall departmental performance.
Reporting and Analysis:
Generate reports and provide data analysis on claims trends, processing times, and outcomes.
Contribute to the development of management reports and presentations regarding claims operations.
$34k-46k yearly est. Auto-Apply 33d ago
Claims Processor I
MUSC (Med. Univ of South Carolina
Claim processor job in Charleston, SC
Under general supervision assures accurate and timely insurance claim processing to include resolving claim edits and paper claims for submittal. Resolves denied/unpaid insurance claims in a timely manner. Entity University Medical Associates (UMA) Only Employees and Financials
Worker Type
Employee
Worker Sub-Type
Regular
Cost Center
CC002058 UMA CORP RC PPA Physician Patient Accounting CC
Pay Rate Type
Hourly
Pay Grade
Health-20
Scheduled Weekly Hours
40
Work Shift
* Account maintenance: Updating registration, authorization issues, identifying charge correction, , processing adjustments as needed and denial follow up according to payer rules and departmental policies.
* Use electronic billing system appropriately to follow up on outstanding denied claims and all no response claims. Corrects claims in electronic billing system for missing or invalid insurance or patient information according to procedures, and places account on hold if you can't resolve
* Follow up on denied or no response claims by calling third party payers or using payer websites. Gathering information from patients or other areas to resolve outstanding denied or no response claims. Researching accounts to take appropriate action necessary to resolve.
* Keep management aware of issues and trends to enhance operations and escalates slow-pay issues to managerial level when necessary.
* Uses payer websites to stay current on payer rules and changes to include reading newsletters and communicating payer/claim issues and trends.
* Maintains 95% quality standards on account follow and activity.
* Maintains productivity standard as set forth by management team.
* Other duties as assigned.
Additional Job Description
Education: High School Degree or Equivalent Work Experience: 0-6months
If you like working with energetic enthusiastic individuals, you will enjoy your career with us!
The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.
Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: ***************************************
$24k-38k yearly est. 60d+ ago
Claims Examiner
Harriscomputer
Claim processor job in South Carolina
Responsibilities & Duties:Claims Processing and Assessment:
Evaluate incoming claims to determine eligibility, coverage, and validity.
Conduct thorough investigations, including reviewing medical records and other relevant documentation.
Analyze policy provisions and contractual agreements to assess claim validity.
Utilize claims management systems to document findings and process claims efficiently.
Communication and Customer Service:
Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements.
Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process.
Address customer concerns and escalate complex issues to senior claims personnel or management as needed.
Compliance and Documentation:
Ensure compliance with company policies, procedures, and regulatory requirements.
Maintain accurate records and documentation related to claims activities.
Follow established guidelines for claims adjudication and payment authorization.
Quality Assurance and Improvement:
Identify opportunities for process improvement and efficiency within the claims department.
Participate in quality assurance initiatives to uphold service standards and improve claim handling practices.
Collaborate with team members and management to implement best practices and enhance overall departmental performance.
Reporting and Analysis:
Generate reports and provide data analysis on claims trends, processing times, and outcomes.
Contribute to the development of management reports and presentations regarding claims operations.
$24k-38k yearly est. Auto-Apply 33d ago
Claims Processor I - PGBA-27
Palmetto GBA 4.5
Claim processor job in Florence, SC
Logistics: PGBA- one of BlueCross BlueShield's South Carolina subsidiary companies
Location: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. It may be necessary, given the business need to work occasional overtime. The role is located on-site at 200 N Dozier Blvd., Florence, SC 29501.
Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen.
SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act
(
SCA
).
To comply with the McNamara-O'Hara Service Contract Act (SCA), employees must enroll in our health insurance even if they have other health insurance. Employees will receive supplemental pay for health insurance until they are enrolled in our health insurance, first of the month following 28 days after the hire date.
What You'll Do:
Researches and processes claims according to business regulation, internal standards and processing guidelines. Verifies the coding of procedure and diagnosis codes.
Resolves system edits, audits and claims errors through research and use of approved references and investigative sources.
Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.
To Qualify for This Position, You'll Need the Following:
Required Education: High School Diploma or equivalent
Required Skills and Abilities:
Strong analytical, organizational and customer service skills.
Strong oral and written communication skills.
Proficient spelling, punctuation and grammar skills.
Good judgment skills.
Basic business math skills.
Required Software and Tools: Basic office equipment.
We Prefer That You Have the Following:
Preferred Work Experience: 1 year-of experience in a healthcare or insurance environment.
Preferred Skills and Abilities: Ability to use complex mathematical calculations.
Preferred Software and Other Tools: Proficient in word processing and spreadsheet applications. Proficient in database software. Proficient in word processing and spreadsheet applications.
Our Comprehensive Benefits Package Includes the Following:
We offer our employees great benefits and rewards. You will be eligible to participate in the benefits for the first of the month following 28 days of employment.
Subsidized health plans, dental and vision coverage
401k retirement savings plan with company match
Life Insurance
Paid Time Off (PTO)
On-site cafeterias and fitness centers in major locations
Education Assistance
Service Recognition
National discounts to movies, theaters, zoos, theme parks and more
What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
What To Expect Next:
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.
We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.
If you need special assistance or an accommodation while seeking employment, please email ************************ or call ************, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information.
Some states have required notifications. Here's more information.
$23k-34k yearly est. Auto-Apply 6d ago
Claims Examainer - Workers Comp (Southeast State exp needed)
Sedgwick 4.4
Claim processor job in Charleston, SC
By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies
Certified as a Great Place to Work
Fortune Best Workplaces in Financial Services & Insurance
Claims Examainer - Workers Comp (Southeast State exp needed)
Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?
+ Apply your workers compensation knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
+ Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations.
+ Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
+ Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights.
+ Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
+ Enjoy flexibility and autonomy in your daily work, your location, and your career path.
+ Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
**ARE YOU AN IDEAL CANDIDATE?** To analyze workers compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
**ESSENTIAL RESPONSIBLITIES MAY INCLUDE:**
+ Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
+ Negotiating settlement of claims within designated authority.
+ Communicating claim activity and processing with the claimant and the client.
+ Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
**QUALIFICATIONS**
Education & Licensing: Five (5) years of claims management experience or equivalent combination of education and experience required.
+ High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
+ Professional certification as applicable to line of business preferred.
Licensing / Jurisdiction Knowledge: Southeast State Experience
**TAKING CARE OF YOU**
+ Flexible work schedule.
+ Referral incentive program.
+ Career development and promotional growth opportunities.
+ A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
Work environment requirements for entry-level opportunities include -
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Sedgwick retains the discretion to add or to change the duties of the position at any time.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**
**Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
$23k-33k yearly est. 14d ago
Claims Processor I
Medical University of South Carolina 4.6
Claim processor job in Charleston, SC
Under general supervision assures accurate and timely insurance claim processing to include resolving claim edits and paper claims for submittal. Resolves denied/unpaid insurance claims in a timely manner.
Entity
University Medical Associates (UMA) Only Employees and Financials
Worker Type
Employee
Worker Sub-Type
Regular
Cost Center
CC002058 UMA CORP RC PPA Physician Patient Accounting CC
Pay Rate Type
Hourly
Pay Grade
Health-20
Scheduled Weekly Hours
40
Work Shift
Account maintenance: Updating registration, authorization issues, identifying charge correction, , processing adjustments as needed and denial follow up according to payer rules and departmental policies.
Use electronic billing system appropriately to follow up on outstanding denied claims and all no response claims. Corrects claims in electronic billing system for missing or invalid insurance or patient information according to procedures, and places account on hold if you can't resolve
Follow up on denied or no response claims by calling third party payers or using payer websites. Gathering information from patients or other areas to resolve outstanding denied or no response claims. Researching accounts to take appropriate action necessary to resolve.
Keep management aware of issues and trends to enhance operations and escalates slow-pay issues to managerial level when necessary.
Uses payer websites to stay current on payer rules and changes to include reading newsletters and communicating payer/claim issues and trends.
Maintains 95% quality standards on account follow and activity.
Maintains productivity standard as set forth by management team.
Other duties as assigned.
Additional Job Description
Education: High School Degree or Equivalent Work Experience: 0-6months
If you like working with energetic enthusiastic individuals, you will enjoy your career with us!
The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.
Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: ***************************************
$23k-30k yearly est. Auto-Apply 60d+ ago
Associate VB Claims Specialist
UNUM Group 4.4
Claim processor job in Columbia, SC
When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally. To enable this, we provide:
* Award-winning culture
* Inclusion and diversity as a priority
* Performance Based Incentive Plans
* Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability
* Generous PTO (including paid time to volunteer!)
* Up to 9.5% 401(k) employer contribution
* Mental health support
* Career advancement opportunities
* Student loan repayment options
* Tuition reimbursement
* Flexible work environments
* All the benefits listed above are subject to the terms of their individual Plans.
And that's just the beginning…
With 10,000 employees helping more than 39 million people worldwide, every role at Unum is meaningful and impacts the lives of our customers. Whether you're directly supporting a growing family, or developing online tools to help navigate a difficult loss, customers are counting on the combined talents of our entire team. Help us help others, and join Team Unum today!
General Summary:
Minimum starting hourly rate is $22.60
This is an entry level position within the Voluntary Benefits Claims Organization. This position is responsible for the thorough, fair, objective, and timely adjudication of voluntary benefits claims in conjunction with providing technical expertise regarding applicable regulations. This position is responsible for providing excellent customer service and interacts on a regular basis with employees, employers, health care providers and other specialized internal resources.
Incumbents in this role are considered trainees and are assigned a formal mentor for 6-12 months until they are assessed as capable of independent work. Incumbents are primarily responsible for learning and developing the skills, knowledge, and behaviors necessary to successfully adjudicate assigned claims, in accordance with our claims philosophy and policies and procedures.
Incumbent must demonstrate the ability to effectively manage an assigned caseload, exercise discretion and independent judgment, and appropriately render timely claim decisions while demonstrating strong customer service prior to movement to the exempt level claims specialist role.
Principal Duties and Responsibilities:
* Maintain organizational service standards on all assigned claims demonstrating success in developing and implementing effective strategies to manage a caseload of varying size and complexity.
* Develop an understanding and working knowledge of Voluntary Benefits for Unum and Colonial Life, including products, policies, procedures, and contracts.
* Develop an understanding of the applicable contract/policy definitions and relevant provisions, clauses, exclusions, riders, and waivers, as well as regulatory and statutory requirements for claim products administered.
* Develop skill set to determine appropriate risk management strategies through analyzing and applying technical and complex contractual knowledge (policies and provisions) to ensure appropriate eligibility requirements, liability decisions, and benefits payee.
* Develop problem solving skills by demonstrating analytical and logical thinking resulting in the timely and accurate adjudication of a variety of simple to complex voluntary benefits claims.
* Develop a working knowledge of systems needed for claims adjudication.
* Provide excellent customer service and independently respond to all inquiries within service guidelines.
* Responsible for timely and accurate claims review, initiation and completion of appropriate claim validation activities, and referrals/notifications to other areas (i.e., medical assessments, billing, etc.) as appropriate.
* Produce objective, clear documentation and technical rationale for all claim determinations and demonstrate the ability to effectively communicate determinations while ensuring compliance with Voluntary Benefits procedures and all legal requirements including state regulations.
* Partner and coordinate file strategies utilizing specialized resources including nurses, physicians, vocational rehabilitation and assessing medical documentation, when appropriate.
* Ensure a timely and well communicated transfer process when transitioning integrated claims across lines of business, ensuring a coordinated and continuous claims experience for customers.
* Be familiar with specialized workflow requirements and performance standards for any assigned customers.
* May perform other duties as assigned.
Job Specifications:
* 4-year degree preferred or equivalent work experience
* Ability to develop Voluntary Benefits product knowledge and apply a best-in-class service experience
* Medical background, voluntary benefits claims and/or disability management experience preferred
* Possess strong analytical, critical thinking, and problem-solving skills
* Ability to exercise independent judgment and discretion in increasingly complex claim adjudication decisions, including initial decision and ongoing medical management.
* Able to effectively utilize a broad spectrum of resources, materials, and tools needed to assist with the decision-making process
* Strong service and quality orientation.
* Ability to interact effectively and professionally with claimants, employers, medical resources, attorneys, accountants, brokers, sales representatives, etc.
* Demonstrated ability to operate with a sense of urgency and make balanced decisions with the highest degree of integrity and fairness.
* Excellent communication skills, written and verbal
* Meets the standards for this position, as defined in the Talent Management framework
~IN3
#LI-LM2022
Unum and Colonial Life are part of Unum Group, a Fortune 500 company and leading provider of employee benefits to companies worldwide. Headquartered in Chattanooga, TN, with international offices in Ireland, Poland and the UK, Unum also has significant operations in Portland, ME, and Baton Rouge, LA - plus over 35 US field offices. Colonial Life is headquartered in Columbia, SC, with over 40 field offices nationwide.
Unum is an equal opportunity employer, considering all qualified applicants and employees for hiring, placement, and advancement, without regard to a person's race, color, religion, national origin, age, genetic information, military status, gender, sexual orientation, gender identity or expression, disability, or protected veteran status.
The base salary range for applicants for this position is listed below. Unless actual salary is indicated above in the job description, actual pay will be based on skill, geographical location and experience.
$40,000.00-$75,600.00
Additionally, Unum offers a portfolio of benefits and rewards that are competitive and comprehensive including healthcare benefits (health, vision, dental), insurance benefits (short & long-term disability), performance-based incentive plans, paid time off, and a 401(k) retirement plan with an employer match up to 5% and an additional 4.5% contribution whether you contribute to the plan or not. All benefits are subject to the terms and conditions of individual Plans.
Company:
Unum
$40k-75.6k yearly Auto-Apply 6d ago
Claims Processor I
Bluecross Blueshield of South Carolina 4.6
Claim processor job in Columbia, SC
Responsible for the accurate and timely processing of claims.
Logistics: PGBA - one of BlueCross BlueShield's South Carolina subsidiary companies
Location: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role is located on-site at 17 Technology Cir., Columbia, SC, 29203.
Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen.
What You'll Do:
Researches and processes claims according to business regulation, internal standards and processing guidelines. Verifies the coding of procedure and diagnosis codes.
Resolves system edits, audits and claims errors through research and use of approved references and investigative sources.
Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.
To Qualify for This Position, You'll Need the Following:
Required Education: High School Diploma or equivalent
Required Skills and Abilities:
Strong analytical, organizational and customer service skills.
Strong oral and written communication skills.
Proficient spelling, punctuation and grammar skills.
Good judgment skills.
Basic business math skills.
Required Software and Tools: Basic office equipment.
We Prefer That You Have the Following:
Preferred Work Experience: 1 year-of experience in a healthcare or insurance environment.
Preferred Skills and Abilities: Ability to use complex mathematical calculations.
Preferred Software and Other Tools: Proficient in word processing and spreadsheet applications. Proficient in database software.
Our Comprehensive Benefits Package Includes the Following:
We offer our employees great benefits and rewards. You will be eligible to participate in the benefits for the first of the month following 28 days of employment.
Subsidized health plans, dental and vision coverage
401k retirement savings plan with company match
Life Insurance
Paid Time Off (PTO)
On-site cafeterias and fitness centers in major locations
Education Assistance
Service Recognition
National discounts to movies, theaters, zoos, theme parks and more
What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
What To Expect Next:
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.
We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.
If you need special assistance or an accommodation while seeking employment, please email ************************ or call ************, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information.
Some states have required notifications. Here's more information.
$33k-51k yearly est. Auto-Apply 34d ago
Bodily Injury Claims Specialist
Auto-Owners Insurance 4.3
Claim processor job in Columbia, SC
We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team.
Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated individual to join our Claims department as a Bodily Injury Claims Representative. The position requires the person to:
Assemble facts, determine coverage, evaluate the amount of loss, analyze legal liability, make payments in accordance with coverage, damage and liability determination, and perform other functions or duties to properly adjust the loss.
Study insurance policies, endorsements, and forms to develop an understanding of insurance coverage.
Follow claims handling procedures and participate in claim negotiations and settlements.
Deliver a high level of customer service to our agents, insureds, and others.
Devise alternative approaches to provide appropriate service, dependent upon the circumstances.
Meet with people involved with claims, sometimes outside of our office environment.
Handle investigations by telephone, email, mail, and on-site investigations.
Maintain appropriate adjuster's license(s), if required by statute in the jurisdiction employed, within the time frame prescribed by the Company or statute.
Handle complex and unusual exposure claims effectively through on-site investigations and through participation in mediations, settlement conferences, and trials.
Handle confidential information according to Company standards and in accordance with any applicable law, regulation, or rule.
Assist in the evaluation and selection of outside counsel.
Maintain punctual attendance according to an assigned work schedule at a Company approved work location.
Desired Skills & Experience
A minimum of three years of insurance claims related experience.
The ability to organize and conduct an investigation involving complex issues and assimilate the information to reach a logical and timely decision.
The ability to effectively understand, interpret and communicate policy language.
The dissemination of appropriate claim handling techniques so that others involved in the claim process are understanding of issues.
Benefits
Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you!
Equal Employment Opportunity
Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law.
*Please note that the ability to work in the U.S. without current or future sponsorship is a requirement.
#LI-DNI
$33k-46k yearly est. Auto-Apply 23d ago
Claims Mitigation & Management Specialist
The Nuclear Company
Claim processor job in Columbia, SC
Job Description
The Nuclear Company is the fastest growing startup in the nuclear and energy space creating a never before seen fleet-scale approach to building nuclear reactors. Through its design-once, build-many approach and coalition building across communities, regulators, and financial stakeholders, The Nuclear Company is committed to delivering safe and reliable electricity at the lowest cost, while catalyzing the nuclear industry toward rapid development in America and globally.
About the role
The Nuclear Company is looking for an experienced Claims Mitigation & Management Specialist to support the deployment of major nuclear reactor projects. This role will focus on contract formation, administration, and proactive claims prevention. You will work closely with project teams, contract managers, and leadership to identify and address potential risks, respond to claims, and ensure contractual compliance across complex, utility-scale nuclear energy projects.
Responsibilities
Proactively identify potential claims and disputes on projects.
Develop and implement strategies for early claims identification and mitigation.
Provide guidance to project teams on contract administration and documentation.
Conduct detailed forensic analysis of project documentation for claims assessment.
Quantify cost and schedule impacts of potential claims, including delay and disruption.
Prepare comprehensive claims position papers and reports.
Support the negotiation process for claims and disputes.
Assist in preparing for and participating in dispute resolution forums (e.g., mediation, arbitration).
Develop and maintain a robust claims log, tracking all active and potential claims.
Ensure all claims-related documentation is meticulously organized.
Prepare regular reports on claims status, liabilities, and resolution progress.
Work closely with Project Controls, Contracts, and Legal teams on claims management.
Participate in project reviews to provide insights on claims trends.
Experience
Bachelor's degree in Engineering, Construction Management, Quantity Surveying, Law, or a related field.
8+ years of progressive experience in claims management, dispute resolution, or contract administration.
3+ years of focused claims management experience.
Experience on energy mega-projects (utility-scale, high capital, high complexity).
Experience on nuclear energy projects is highly valued.
Demonstrated expertise in contract formation, negotiation, and administration.
Exceptional analytical, critical thinking, and problem-solving skills.
Excellent written and verbal communication and negotiation skills.
Proficiency in project management software, scheduling tools, and advanced Excel.
Ability to work effectively under pressure and manage multiple priorities.
Knowledge of construction law and dispute resolution processes.
Benefits
Competitive compensation packages
401k with company match
Medical, dental, vision plans
Generous vacation policy, plus holidays
Estimated Starting Salary Range
The estimated starting salary range for this role is $121,000 - $143,000 annually less applicable withholdings and deductions, paid on a bi-weekly basis. The actual salary offered may vary based on relevant factors as determined in the Company's discretion, which may include experience, qualifications, tenure, skill set, availability of qualified candidates, geographic location, certifications held, and other criteria deemed pertinent to the particular role.
EEO Statement
The Nuclear Company is an equal opportunity employer committed to fostering an environment of inclusion in the workplace. We provide equal employment opportunities to all qualified applicants and employees without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other protected characteristic. We prohibit discrimination in all aspects of employment, including hiring, promotion, demotion, transfer, compensation, and termination.
Export Control
Certain positions at The Nuclear Company may involve access to information and technology subject to export controls under U.S. law. Compliance with these export controls may result in The Nuclear Company limiting its consideration of certain applicants.
$25k-45k yearly est. 27d ago
Customer Claims Representative
Service Pros Auto Glass
Claim processor job in Anderson, SC
Job Description
Customer Claims Representative - Anderson
Join the Service Pros Auto Glass team inside our partnered dealerships! You'll engage customers, spot glass-replacement opportunities, and coordinate quick, professional service - all while building strong relationships and developing a personal team. This role is perfect for a teachable person who loves being part of a supportive, winning team.
What You'll Do:
Engage customers in the service drive and identify windshield replacement needs.
Educate and guide customers through their options and next steps.
Build strong relationships with service advisors, managers, and technicians.
Encourage dealership referrals and hit daily/weekly sales goals.
Schedule and coordinate on-site glass services.
Keep accurate records of leads, interactions, and completed jobs.
Represent the company with a professional, positive attitude.
What Makes You a Great Fit:
Experience in customer service or sales is a plus, but not required.
Strong communication and people skills.
A self-motivated, proactive approach - you enjoy taking the lead.
Team-oriented mindset with a friendly, professional appearance.
Valid driver's license and reliable transportation.
What We Offer:
A fun, energetic, team-first culture
Ability to earn $1000 - $2500 per week
You are
paid on a weekly basis
Promotion from within and clear growth paths
Ongoing training and development
Team events, company outings, and a culture that celebrates wins
$28k-40k yearly est. 12d ago
Embedded ROI Processor
Datavant
Claim processor job in Columbia, SC
Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care.
By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare.
**You will:**
+ Receive and process requests for patient health information in accordance with Company and Facility policies and procedures.
+ Maintain confidentiality and security with all privileged information.
+ Maintain working knowledge of Company and facility software.
+ Adhere to the Company's and Customer facilities Code of Conduct and policies.
+ Inform manager of work, site difficulties, and/or fluctuating volumes.
+ Assist with additional work duties or responsibilities as evident or required.
+ Consistent application of medical privacy regulations to guard against unauthorized disclosure.
+ Responsible for managing patient health records.
+ Responsible for safeguarding patient records and ensuring compliance with HIPAA standards.
+ Prepares new patient charts, gathering documents and information from paper sources and/or electronic health record.
+ Ensures medical records are assembled in standard order and are accurate and complete.
+ Creates digital images of paperwork to be stored in the electronic medical record.
+ Responds to requests for patient records, both within the facility and by external sources, retrieving them and transmitting them appropriately.
+ Answering of inbound/outbound calls.
+ May assist with patient walk-ins.
+ May assist with administrative duties such as handling faxes, opening mail, and data entry.
+ Must meet productivity expectations as outlined at specific site.
+ May schedules pick-ups.
+ Other duties as assigned.
**What you will bring to the table:**
+ High School Diploma or GED.
+ Ability to commute between locations as needed.
+ Able to work overtime during peak seasons when required.
+ Basic computer proficiency.
+ Comfortable utilizing phones, fax machine, printers, and other general office equipment on a regular basis.
+ Professional verbal and written communication skills in the English language.
+ Detail and quality oriented as it relates to accurate and compliant information for medical records.
+ Strong data entry skills.
+ Must be able to work with minimum supervision responding to changing priorities and role needs.
+ Ability to organize and manage multiple tasks.
+ Able to respond to requests in a fast-paced environment.
**Bonus points if:**
+ Experience in a healthcare environment.
+ Previous production/metric-based work experience.
+ In-person customer service experience.
+ Ability to build relationships with on-site clients and customers.
+ Comfortable bringing new ideas, process improvement suggestions, and feedback to internal stakeholders.
We are committed to building a diverse team of Datavanters who are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status.
Our compensation philosophy is to be externally competitive, internally fair, and not win or lose on compensation. Salary ranges for this position are developed with the support of benchmarks and industry best practices.
We're building a high-growth, high-autonomy culture. We rely less on job titles and more on cultivating an environment where anyone can contribute, the best ideas win, and personal growth is driven by expanding impact. The range posted is for a given job title, which can include multiple levels. Individual rates for the same job title may differ based on their level, responsibilities, skills, and experience for a specific job. The estimated _salary range_ for this role is $15.00 - $18.32. _Comp target_ is between $16.00 - $17.00 for this role
_At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your responses will be_ _anonymous and_ _used to help us identify areas of improvement in our recruitment process._ _(_ _We can only see aggregate responses, not individual responses. In fact, we aren't even able to see if you've responded or not_ _.)_ _Responding is your choice and it will not be used in any way in our hiring process_ _._
Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role.
The estimated base pay range per hour for this role is:
$15-$18.32 USD
To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion.
This job is not eligible for employment sponsorship.
Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here (************************************************** . Know Your Rights (*********************************************************************** , explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay.
At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren't even able to see whether you've responded.) Responding is entirely optional and will not affect your application or hiring process in any way.
Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, (************************************************************** Id=**********48790029&layout Id=**********48795462) by selecting the 'Interview Accommodation Request' category. You will need your requisition ID when submitting your request, you can find instructions for locating it here (******************************************************************************************************* . Requests for reasonable accommodations will be reviewed on a case-by-case basis.
For more information about how we collect and use your data, please review our Privacy Policy (**************************************** .
$15-18.3 hourly 15d ago
3rd shift Doughnut Processor
Krispy Kreme Doughnut-Florence, Sc 4.7
Claim processor job in Florence, SC
Job Description
Job duties include filling doughnuts, decorating doughnuts, placing doughnuts on trays, screens or in boxes. This job is 3rd shift. The hours are 10pm-6am. 40 hours per week, pay starts at 15.00 per hour. Schedule is Tuesday - Saturday. Off Sunday and Monday.
Requirements/Responsibilities
Must be able to lift 50lbs. Must be self motivated and able to work with minimal supervison. Must be dependable and hard working.
Special Instructions
Please do not send any emails, resumes, or call.
We are making it really easy to apply for this position.
Simply submit a ZippyApp application package which may include the Common Employment Application, Resume, and a Cover Letter. In your Cover Letter, please write a short paragraph describing yourself and why you would make a great addition to our team.
ZippyApp is the Common Employment Application for online and mobile that allows you to apply for jobs with one click, and is being accepted at a growing number of businesses each day.
$20k-29k yearly est. 4d ago
Contribution Processor
Confidential-Finance
Claim processor job in West Columbia, SC
Job Title:
Contribution Processor
Job Level:
Level I
Department:
Contribution Processing
Reports to:
Contribution Processing Supervisor
Salesforce Access Level:
Salary Range:
Position Type:
Remote/On-site/Both
Full Time / On-site
Job Description
Role Objectives
The Contribution Processor is responsible for the processing of incoming contributions and loan payment transactions received by PenServ. The processor must be familiar with most aspects of the Contribution Processing area.
Essential Job Duties and Responsibilities
· Processes incoming simple contributions and loan transactions with little assistance needed
· Reconciles contributions to employer payroll file and verifies payroll processing is accurate
· Generates payroll reports for employers and trade reports for Cash Management
· Reports contribution and loan payment discrepancies to plan managers
· Understands the transaction flow of the job queue and the STP tasks
· Maintains appropriate processing deadlines
· Monitors Job Queue
· Able to troubleshoot simple error messages during processing
Supervisory Responsibilities
None
Qualifications and Education Requirements
· Microsoft Office skills - data entry skills.
· Proficient in Microsoft Excel.
· Able to reconcile and balance cash transactions.
· Relevant work experience related to accounting or finance.
· Strong organizational skills; strong attention to detail.
· Good communication skills; good team player.
Preferred Skills/Abilities
· 2 to 4 Year degree or equivalent experience required; degree in accounting/finance preferred
· At least a year's experience in payroll processing or financial transaction experience.
Physical Job Requirements
Most positions require prolonged periods of sitting at a desk and working on a computer. Must be able to lift 15 pounds at times.
$22k-31k yearly est. 10d ago
Mortage Processor
Snelling Staffing 4.4
Claim processor job in Lexington, SC
Job Description
Grow your career with this established business in Greater Lexington, SC
Hours: 9am to 5pm, optional 1hr lunch
NO Health Benefits
Mortgage Processor- 2 years experience at least
Phones (inbound and outbound)
Process Loans (residential only)
Busier Months- Spring/March
Apply and call us at
$28k-34k yearly est. 12d ago
Claims Processor I - PGBA-27
PGBA 4.2
Claim processor job in Florence, SC
Logistics: PGBA- one of BlueCross BlueShield's South Carolina subsidiary companies
Location: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. It may be necessary, given the business need to work occasional overtime. The role is located on-site at 200 N Dozier Blvd., Florence, SC 29501.
Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen.
SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act
(
SCA
).
To comply with the McNamara-O'Hara Service Contract Act (SCA), employees must enroll in our health insurance even if they have other health insurance. Employees will receive supplemental pay for health insurance until they are enrolled in our health insurance, first of the month following 28 days after the hire date.
What You'll Do:
Researches and processes claims according to business regulation, internal standards and processing guidelines. Verifies the coding of procedure and diagnosis codes.
Resolves system edits, audits and claims errors through research and use of approved references and investigative sources.
Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.
To Qualify for This Position, You'll Need the Following:
Required Education: High School Diploma or equivalent
Required Skills and Abilities:
Strong analytical, organizational and customer service skills.
Strong oral and written communication skills.
Proficient spelling, punctuation and grammar skills.
Good judgment skills.
Basic business math skills.
Required Software and Tools: Basic office equipment.
We Prefer That You Have the Following:
Preferred Work Experience: 1 year-of experience in a healthcare or insurance environment.
Preferred Skills and Abilities: Ability to use complex mathematical calculations.
Preferred Software and Other Tools: Proficient in word processing and spreadsheet applications. Proficient in database software. Proficient in word processing and spreadsheet applications.
Our Comprehensive Benefits Package Includes the Following:
We offer our employees great benefits and rewards. You will be eligible to participate in the benefits for the first of the month following 28 days of employment.
Subsidized health plans, dental and vision coverage
401k retirement savings plan with company match
Life Insurance
Paid Time Off (PTO)
On-site cafeterias and fitness centers in major locations
Education Assistance
Service Recognition
National discounts to movies, theaters, zoos, theme parks and more
What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
What To Expect Next:
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.
We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.
If you need special assistance or an accommodation while seeking employment, please email ************************ or call ************, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information.
Some states have required notifications. Here's more information.
$27k-41k yearly est. Auto-Apply 2d ago
Associate VB Claims Specialist
Unum Group 4.4
Claim processor job in Columbia, SC
When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally. To enable this, we provide:
+ Award-winning culture
+ Inclusion and diversity as a priority
+ Performance Based Incentive Plans
+ Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability
+ Generous PTO (including paid time to volunteer!)
+ Up to 9.5% 401(k) employer contribution
+ Mental health support
+ Career advancement opportunities
+ Student loan repayment options
+ Tuition reimbursement
+ Flexible work environments
**_*All the benefits listed above are subject to the terms of their individual Plans_** **.**
And that's just the beginning...
With 10,000 employees helping more than 39 million people worldwide, every role at Unum is meaningful and impacts the lives of our customers. Whether you're directly supporting a growing family, or developing online tools to help navigate a difficult loss, customers are counting on the combined talents of our entire team. Help us help others, and join Team Unum today!
**General Summary:**
Minimum starting hourly rate is $22.60
This is an entry level position within the Voluntary Benefits Claims Organization. This position is responsible for the thorough, fair, objective, and timely adjudication of voluntary benefits claims in conjunction with providing technical expertise regarding applicable regulations. This position is responsible for providing excellent customer service and interacts on a regular basis with employees, employers, health care providers and other specialized internal resources.
Incumbents in this role are considered trainees and are assigned a formal mentor for 6-12 months until they are assessed as capable of independent work. Incumbents are primarily responsible for learning and developing the skills, knowledge, and behaviors necessary to successfully adjudicate assigned claims, in accordance with our claims philosophy and policies and procedures.
Incumbent must demonstrate the ability to effectively manage an assigned caseload, exercise discretion and independent judgment, and appropriately render timely claim decisions while demonstrating strong customer service prior to movement to the exempt level claims specialist role.
**Principal Duties and Responsibilities:**
+ Maintain organizational service standards on all assigned claims demonstrating success in developing and implementing effective strategies to manage a caseload of varying size and complexity.
+ Develop an understanding and working knowledge of Voluntary Benefits for Unum and Colonial Life, including products, policies, procedures, and contracts.
+ Develop an understanding of the applicable contract/policy definitions and relevant provisions, clauses, exclusions, riders, and waivers, as well as regulatory and statutory requirements for claim products administered.
+ Develop skill set to determine appropriate risk management strategies through analyzing and applying technical and complex contractual knowledge (policies and provisions) to ensure appropriate eligibility requirements, liability decisions, and benefits payee.
+ Develop problem solving skills by demonstrating analytical and logical thinking resulting in the timely and accurate adjudication of a variety of simple to complex voluntary benefits claims.
+ Develop a working knowledge of systems needed for claims adjudication.
+ Provide excellent customer service and independently respond to all inquiries within service guidelines.
+ Responsible for timely and accurate claims review, initiation and completion of appropriate claim validation activities, and referrals/notifications to other areas (i.e., medical assessments, billing, etc.) as appropriate.
+ Produce objective, clear documentation and technical rationale for all claim determinations and demonstrate the ability to effectively communicate determinations while ensuring compliance with Voluntary Benefits procedures and all legal requirements including state regulations.
+ Partner and coordinate file strategies utilizing specialized resources including nurses, physicians, vocational rehabilitation and assessing medical documentation, when appropriate.
+ Ensure a timely and well communicated transfer process when transitioning integrated claims across lines of business, ensuring a coordinated and continuous claims experience for customers.
+ Be familiar with specialized workflow requirements and performance standards for any assigned customers.
+ May perform other duties as assigned.
**Job Specifications:**
+ 4-year degree preferred or equivalent work experience
+ Ability to develop Voluntary Benefits product knowledge and apply a best-in-class service experience
+ Medical background, voluntary benefits claims and/or disability management experience preferred
+ Possess strong analytical, critical thinking, and problem-solving skills
+ Ability to exercise independent judgment and discretion in increasingly complex claim adjudication decisions, including initial decision and ongoing medical management.
+ Able to effectively utilize a broad spectrum of resources, materials, and tools needed to assist with the decision-making process
+ Strong service and quality orientation.
+ Ability to interact effectively and professionally with claimants, employers, medical resources, attorneys, accountants, brokers, sales representatives, etc.
+ Demonstrated ability to operate with a sense of urgency and make balanced decisions with the highest degree of integrity and fairness.
+ Excellent communication skills, written and verbal
+ Meets the standards for this position, as defined in the Talent Management framework
~IN3
\#LI-LM2022
Unum and Colonial Life are part of Unum Group, a Fortune 500 company and leading provider of employee benefits to companies worldwide. Headquartered in Chattanooga, TN, with international offices in Ireland, Poland and the UK, Unum also has significant operations in Portland, ME, and Baton Rouge, LA - plus over 35 US field offices. Colonial Life is headquartered in Columbia, SC, with over 40 field offices nationwide.
Unum is an equal opportunity employer, considering all qualified applicants and employees for hiring, placement, and advancement, without regard to a person's race, color, religion, national origin, age, genetic information, military status, gender, sexual orientation, gender identity or expression, disability, or protected veteran status.
The base salary range for applicants for this position is listed below. Unless actual salary is indicated above in the job description, actual pay will be based on skill, geographical location and experience.
$40,000.00-$75,600.00
Additionally, Unum offers a portfolio of benefits and rewards that are competitive and comprehensive including healthcare benefits (health, vision, dental), insurance benefits (short & long-term disability), performance-based incentive plans, paid time off, and a 401(k) retirement plan with an employer match up to 5% and an additional 4.5% contribution whether you contribute to the plan or not. All benefits are subject to the terms and conditions of individual Plans.
Company:
Unum
$40k-75.6k yearly 6d ago
Claims Mitigation & Management Specialist
The Nuclear Company
Claim processor job in Columbia, SC
The Nuclear Company is the fastest growing startup in the nuclear and energy space creating a never before seen fleet-scale approach to building nuclear reactors. Through its design-once, build-many approach and coalition building across communities, regulators, and financial stakeholders, The Nuclear Company is committed to delivering safe and reliable electricity at the lowest cost, while catalyzing the nuclear industry toward rapid development in America and globally.
About the role
The Nuclear Company is looking for an experienced Claims Mitigation & Management Specialist to support the deployment of major nuclear reactor projects. This role will focus on contract formation, administration, and proactive claims prevention. You will work closely with project teams, contract managers, and leadership to identify and address potential risks, respond to claims, and ensure contractual compliance across complex, utility-scale nuclear energy projects.
Responsibilities
Proactively identify potential claims and disputes on projects.
Develop and implement strategies for early claims identification and mitigation.
Provide guidance to project teams on contract administration and documentation.
Conduct detailed forensic analysis of project documentation for claims assessment.
Quantify cost and schedule impacts of potential claims, including delay and disruption.
Prepare comprehensive claims position papers and reports.
Support the negotiation process for claims and disputes.
Assist in preparing for and participating in dispute resolution forums (e.g., mediation, arbitration).
Develop and maintain a robust claims log, tracking all active and potential claims.
Ensure all claims-related documentation is meticulously organized.
Prepare regular reports on claims status, liabilities, and resolution progress.
Work closely with Project Controls, Contracts, and Legal teams on claims management.
Participate in project reviews to provide insights on claims trends.
Experience
Bachelor's degree in Engineering, Construction Management, Quantity Surveying, Law, or a related field.
8+ years of progressive experience in claims management, dispute resolution, or contract administration.
3+ years of focused claims management experience.
Experience on energy mega-projects (utility-scale, high capital, high complexity).
Experience on nuclear energy projects is highly valued.
Demonstrated expertise in contract formation, negotiation, and administration.
Exceptional analytical, critical thinking, and problem-solving skills.
Excellent written and verbal communication and negotiation skills.
Proficiency in project management software, scheduling tools, and advanced Excel.
Ability to work effectively under pressure and manage multiple priorities.
Knowledge of construction law and dispute resolution processes.
Benefits
Competitive compensation packages
401k with company match
Medical, dental, vision plans
Generous vacation policy, plus holidays
Estimated Starting Salary Range
The estimated starting salary range for this role is $121,000 - $143,000 annually less applicable withholdings and deductions, paid on a bi-weekly basis. The actual salary offered may vary based on relevant factors as determined in the Company's discretion, which may include experience, qualifications, tenure, skill set, availability of qualified candidates, geographic location, certifications held, and other criteria deemed pertinent to the particular role.
EEO Statement
The Nuclear Company is an equal opportunity employer committed to fostering an environment of inclusion in the workplace. We provide equal employment opportunities to all qualified applicants and employees without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other protected characteristic. We prohibit discrimination in all aspects of employment, including hiring, promotion, demotion, transfer, compensation, and termination.
Export Control
Certain positions at The Nuclear Company may involve access to information and technology subject to export controls under U.S. law. Compliance with these export controls may result in The Nuclear Company limiting its consideration of certain applicants.
How much does a claim processor earn in Charleston, SC?
The average claim processor in Charleston, SC earns between $19,000 and $47,000 annually. This compares to the national average claim processor range of $26,000 to $62,000.
Average claim processor salary in Charleston, SC
$30,000
What are the biggest employers of Claim Processors in Charleston, SC?
The biggest employers of Claim Processors in Charleston, SC are: