Claim processor jobs in Mount Pleasant, 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: ***************************************

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.

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.

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 Claim Examiner - Workers Comp (Southeast Experience Required) 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 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?** We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion. **PRIMARY PURPOSE** **:** To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. + Negotiates settlement of claims within designated authority. + Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim. + Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level. + Prepares necessary state fillings within statutory limits. + Manages the litigation process; ensures timely and cost effective claims resolution. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required. **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred. **Experience** : Five (5) years of claims management experience or equivalent combination of education and experience required **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. 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. Management 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. **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**

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: ***************************************

+ Responsible for the accurate and timely processing of claims. + Research and processes claims according to business regulation, internal standards and processing guidelines. **Responsibilities:** + 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. **Skills:** + **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. + **Required Software and Tools:** Proficient in word processing and spreadsheet applications. Proficient in database software. **Education:** + **Required Education Level and Degree Type** : High School Diploma or equivalent + Required Work Experience: Experience processing, researching and adjudicating claims **Experience:** + Experience processing, researching and adjudicating claims **About US Tech Solutions:** US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit *********************** (********************************** . US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Position Summary** Review and adjust SF (self-funded), FI (fully insured), Reinsurance, and/or RX claims; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. Process provider refunds and returned checks. May handle customer service inquiries and problems. + Perform adjustments across all dollar amount level on customer service platforms by using technical and claims processing expertise. + Applies medical necessity guidelines, determine coverage, complete eligibility verification, identify discrepancies, and apply all cost containment measures to assist in the claim adjudication process. + Performs claim re-work calculations. + Follow through completion of claim overpayments, underpayments, and any other irregularities. + Process complex non-routine Provider Refunds and Returned Checks. + Review and interpret medical contract language using provider contracts to confirm whether a claim is overpaid to allocate refund checks. + Handle telephone and written inquiries related to requests for pre-approvals/pre-authorizations, reconsiderations, or appeals. + Ensures all compliance requirements are satisfied and that all payments are made following company practices and procedures. + Review and handle relevant correspondences assigned to the team that may result in adjustment to claims. + May provide job shadowing to lesser experience staff. + Utilize all resource materials to manage job responsibilities. **Required Qualifications** + 2+ years medical claim processing experience. + Experience in a production environment. + Demonstrated ability to handle multiple assignments competently, accurately, and efficiently. + Effective communications, organizational, and interpersonal skills. **Preferred Qualifications** + DG system claims processing experience. + Associate degree preferred. **Education** + High School Diploma or GED. **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $18.50 - $42.35 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 12/23/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Job DescriptionDescription: Command Investigations, LLC is looking for Claims Investigator to become part of a dynamic team. This is a great opportunity for individuals with prior SIU experience who demonstrate integrity, independence, and a drive to succeed in a fast-paced investigative environment. Why You Will Love Working with Command Investigations, LLC? At Command Investigations, we are invested in YOU! We know, together, we can Lead with Excellence to provide top tier Service with Integrity that drives Results! Pay: $28.00 - $32.00 per hour Schedule: Part-time, on-call. Due to the nature of this role, there is no guarantee of hours or case assignments; however, we pride ourselves on distributing available cases fairly. Our employees have opportunities to grow within a nationally recognized organization in an exciting and evolving industry. How We Take Care of You (for Full Time positions): Accrued Paid Time Off Medical, Dental, Vision, and Life Insurance 401(k) Plan Employee Referral Program At Command, we take care of our own. Our benefits plan helps keep you and your family healthy, happy, and secure. What You will Do: In this role, you will conduct claims investigations by gathering evidence, interviewing involved parties, documenting findings, and preparing comprehensive, detailed reports for client review. Conduct investigations related to insurance claims, including workers' compensation, general liability, auto, and property cases Obtain in-person recorded statements from claimants, witnesses, and involved parties Capture detailed scene photographs to support investigative findings Prepare comprehensive, factual, and well-organized investigative reports within required deadlines Review case materials and identify inconsistencies or areas requiring further inquiry Communicate effectively with clients and internal teams to provide case updates and ensure investigative objectives are met Utilize sound judgment and discretion while maintaining confidentiality and compliance with company standards Manage multiple case assignments simultaneously while prioritizing tasks to meet strict due dates Operate investigative equipment, including digital recorders and cameras, with proficiency and accuracy Special Note: This role requires you to supply your own equipment, including but not limited to, a camera and a digital recorder. Certain equipment specifications or minimum standards may apply. Requirements: What We are Looking For: Exceptional attention to detail and accuracy Strong work ethic with a willingness to learn and adapt Team-oriented mindset and open-minded attitude Ability to thrive in a focused, detail-driven, and repetitive environment Strong computer skills and working knowledge of Microsoft Suite, specifically in Word and Outlook Excellent written and verbal communication skills What You Will Bring: 3-5 years of experience required Prior experience with multi-lines investigations strongly preferred Reside within a 60-mile radius of the posted location required Multi-lingual is a plus High school diploma or equivalent required College degree strongly preferred Proficient reading skills and ability to follow directions required Must be able to work independently, provide excellent customer service, and demonstrate strong interpersonal, organizational, and multi-tasking skills. Flexibility and effective time management are required Flexible to work overtime preferred Regular, predictable, and full attendance, as assigned, is an essential function of the job Willingness to work the required schedule Complete a Command Investigations, LLC employment application, submit to pre-employment tasks as required for employment Physical Requirements: The physical and mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The employee will be required to remember and understand certain instructions, guidelines, or other information. The employee should have the ability to lift up to and including 25lbs/11.34kg on occasion. The employee will be required to sit, stand, and/or walk for long periods at a time. The employee will be required to enter text or data into a computer or other machine by means of a traditional keyboard. Traditional Keyboard refers to a panel of keys used as the primary input device on a computer, typographic machine, or 10-Key numeric keypad. Specific vision abilities required for this position include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust focus. The associate must be able to hear, understand, and distinguish speech and surrounding sounds, such as traffic, environmental noises, or standard office activity. About Command Investigations Command Investigations, founded in 2012, is a nationally recognized investigations firm offering surveillance, remote investigations, desktop intelligence, and specialty services to the insurance defense industry. Grounded in core values of integrity, service, and results, we deliver fast, reliable outcomes and treat every client like they are our only client. Our team leverages cutting-edge technology to stay at the forefront of the industry. With headquarters in Lake Mary, Florida, our experts provide services across the U.S. on a national scale. Command Investigations, LLC is an Equal Opportunity Employer.

About the Role This role is responsible for creating vendor claims for various activities to be sent to TD SYNNEX Vendor partners for reconciliation and collection. The role identifies, researches and resolves items to minimize risk and maximize profit. Responsible for all vendor claim and reconciliation processes for vendor promotions, marketing activities, price protection and vendor rebates. What You'll Do * Performs daily and monthly accounting processes and transactions. * Prepares and submits financial claims (Special Pricing, Marketing, Rebate, etc.) to vendors per required formatting and deadlines. * Completes various account analyses and/or account reconciliations. * Researches and resolves issues and claim denials received from vendor. * Resolves and escalates issues to management in a timely manner. * General understanding of the business outside of Vendor Claims and Operations. What We're Looking For * Entry Level (0 to 1 Years of relevant work experience) * High School Graduate required * Associate Degree preferred * Possesses strong data entry skills. * Able to recognize and attend to important details with accuracy and efficiency. * Understand, communicate, and collaborate effectively with people across various identities. * Possesses strong organizational and time management skills, driving tasks to completion. * Able to constructively work under stress and pressure when faced with high workloads and deadlines. * Able to use relevant computer systems and applications at a basic level. * Able to be immobile for long extended periods. Working Conditions: * Professional, office environment. #LI-MI1 Key Skills At TD SYNNEX, our values guide everything we do: Together, We Own It, We Dare to Go, We Grow and Win, and above all, We Do the Right Thing. These principles shape how we work with each other, our partners, and our communities as we drive innovation and create lasting impact. What's In It For You? * Elective Benefits: Our programs are tailored to your country to best accommodate your lifestyle. * Grow Your Career: Accelerate your path to success (and keep up with the future) with formal programs on leadership and professional development, and many more on-demand courses. * Elevate Your Personal Well-Being: Boost your financial, physical, and mental well-being through seminars, events, and our global Life Empowerment Assistance Program. * Diversity, Equity & Inclusion: It's not just a phrase to us; valuing every voice is how we succeed. Join us in celebrating our global diversity through inclusive education, meaningful peer-to-peer conversations, and equitable growth and development opportunities. * Make the Most of our Global Organization: Network with other new co-workers within your first 30 days through our onboarding program. * Connect with Your Community: Participate in internal, peer-led inclusive communities and activities, including business resource groups, local volunteering events, and more environmental and social initiatives. Don't meet every single requirement? Apply anyway. At TD SYNNEX, we're proud to be recognized as a great place to work and a leader in the promotion and practice of diversity, equity and inclusion. If you're excited about working for our company and believe you're a good fit for this role, we encourage you to apply. You may be exactly the person we're looking for! We are an equal opportunity employer and committed to building a team that represents and empowers a variety of backgrounds, perspectives, and skills. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, gender, gender identity or expression, sexual orientation, protected veteran status, disability, genetics, age, or any other characteristic protected by law. TD SYNNEX is an E-Verify company

Job Title: Revenue Cycle Claim Specialist Company Overview: Eau Claire Cooperative Health Center, Inc. (dba Cooperative Health) is a leading community health center serving the Midlands of South Carolina since 1981. It is deeply rooted in its mission of providing accessible, high quality, compassion health care in the spirit of the Good Samaritan. The organization's values of: treating each other with respect, putting people first, being excellent at what we do, promoting a collaborative work environment, improving community/population health, fostering innovative thinkers, and getting results, are core attributes of every employee at Cooperative Health. Position Summary: The Revenue Cycle Claim Specialist will be assigned to specific Practice Locations and is responsible for increasing billing efficiency, accuracy and profitability through working Missing Slips and creating claims. Responsibilities will include, review of insurances, billing services, payer specific billing guidelines and other Billing duties and tasks as assigned by Revenue Cycle Supervisor, Sr. Lead Revenue Cycle Specialist and/or Revenue Cycle Director. This position may be considered for a future hybrid schedule. Principles Responsibilities: * Effectively communicates with Revenue Cycle Leadership staff to clarify coding and billing for accuracy. * Track and report insurance, billing and coding errors that impact claim creation. * Report identified coding and practice management system issues to Revenue Cycle Leadership. * Attend required Revenue Cycle meetings in person and/or via Zoom or Teams. * Perform daily Encounter review to assure general documentation supports coding on Superbills. * Perform Daily Day End review to identify the need for additional claim edits and validate charges. * Review and prepare claims for submission to various insurance carriers. * Responsible for responding to emails and Athena text pertaining to claim corrections. * Responsible for performing other billing task as directed by Revenue Cycle Leadership. Education & Experience: * Education - Min. High School Diploma with some college * Minimum 2 years working Registration in a Physician's office * Minimum 1 year experience performing Patient Check-in/Registration (Athena experience required) * Minimum 1 year experience performing Claim Creation (Athena experience required) * Minimum 2 years Medical Billing and Insurance experience. * Training or working knowledge of ICD-10 and CPT coding. * Current working knowledge of Medical software (Athena) * Knowledge of FQHC Billing Physical Demands * Prolonged periods sitting or standing * Must be able to lift up to 25 pounds. * Be able to sit, stand, stoop, squat for extended periods of time throughout the day. * Standing or walking for extended periods throughout the day. Company Conformance Statement In the performance of respective job assignments, all employees are required to conform with Cooperative Health's: * Board approved policies and procedures; * Confidentiality and professional provisions; * Compliance program; and * Standards of conduct. Cooperative Health provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Cooperative Health complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfers, leaves of absence, compensation and training.

Full-time Description Who Are We? Join our team to take what you love about working in the insurance industry to a whole new level. Serve people all over the country through hundreds of agencies by helping our clients do what they do best. Angela Adams Consulting is the premier resource for agencies providing advice, custom solutions, and remote services related to front and back-office insurance agency operations. Our Consultants, Trainers, Account Managers, Processors, and Insurance Specialists are the most elite professionals in the industry. Become part of a team that truly values collaboration, innovation, and shining the light to success for all independent insurance agencies. Our work schedule is flexible, and most employees work from the comfort of home and enables them to enjoy work and a personal life. We provide Extensive job training, and our Lighthouse Academy is available to all employees - providing an abundance of opportunity for professional growth in a variety of areas. Description To process accounting work as assigned by the account managers, and Direct Bill Lead, in a timely accurate and efficient manner. Duties Enter or reconcile direct bill statements Reconcile company statements Reconcile bank accounts Enter vendor checks Apply credit balances Post cash receipts Keep accurate record of time spent on each task Report inconsistencies to account manager Requirements One year insurance experience - preferred Prior bookkeeping experience - preferred Microsoft Office experience - required Self-motivated Detail oriented Benefits · Health Insurance · Paid time off · Dental Insurance · Vision Insurance · Life Insurance · 401(k) plan with matching Salary Description $15-$19 per hour

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.

Who We Are: NFP, an Aon company, is a multiple Best Places to Work award winner in Business Insurance. We are an organization of consultative advisors and problem solvers. We help companies and individuals around the globe address their most significant risk, workforce, wealth management and retirement challenges through custom solutions and a people-first approach. To learn more, please visit: ******************** Summary: We are seeking a detail-oriented, analytical Stop Loss Claims Auditor to join our team. The ideal candidate will be responsible for processing stop loss claims, ensuring accuracy and compliance with policy terms. This role requires strong analytical skills, attention to detail, the ability to work independently and good communication skills. Key Responsibilities: * Review and process stop loss claims in accordance with policy terms and conditions. * Analyze claim documentation and eligibility records to determine eligibility and coverage. * Communicate with Third Party Administrators and brokers to gather necessary information and resolve claim issues. * Maintain accurate and up-to-date records of all claims processed. * Collaborate with other departments to ensure timely and accurate claim payments. * Prepare and present reports on claim activity and trends to management. Qualifications: * Minimum of 3 years of experience in stop loss claims processing or a related field. * Strong analytical and problem-solving skills. * Excellent written and verbal communication skills. * Proficiency in Microsoft Office Suite, particularly Excel and Word. * Ability to work independently and manage multiple tasks simultaneously. * Knowledge of healthcare insurance and stop loss policies is preferred. * Medical billing experience a plus. * Experience with David Young system a plus What We Offer: We're proud to offer a competitive salary, PTO & paid holidays, 401(k) with match, exclusive discount programs, health & wellness programs, and more. Our PeopleFirst culture focuses on building and nurturing lifelong relationships with our employees because, at the end of the day, we exist to be there for others. The base salary range for this position is $50,000 to $65,000. The base salary offered will be determined by factors including, but not limited to, experience, credentials, education, certifications, skill level required for the position, the scope of the position, and geographic location. Actual base salary offered will be determined on a case-by-case basis. In addition to the base salary, this position may be eligible for performance-based incentives. NFP and You... Better Together! NFP is an inclusive Equal Employment Opportunity employer.

Job Description Dealership Support 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

Who We Are: NFP, an Aon company, is a multiple Best Places to Work award winner in Business Insurance. We are an organization of consultative advisors and problem solvers. We help companies and individuals around the globe address their most significant risk, workforce, wealth management and retirement challenges through custom solutions and a people-first approach. To learn more, please visit: ******************** Summary: We are seeking a detail-oriented, analytical Stop Loss Claims Auditor to join our team. The ideal candidate will be responsible for processing stop loss claims, ensuring accuracy and compliance with policy terms. This role requires strong analytical skills, attention to detail, the ability to work independently and good communication skills. Key Responsibilities: Review and process stop loss claims in accordance with policy terms and conditions. Analyze claim documentation and eligibility records to determine eligibility and coverage. Communicate with Third Party Administrators and brokers to gather necessary information and resolve claim issues. Maintain accurate and up-to-date records of all claims processed. Collaborate with other departments to ensure timely and accurate claim payments. Prepare and present reports on claim activity and trends to management. Qualifications: Minimum of 3 years of experience in stop loss claims processing or a related field. Strong analytical and problem-solving skills. Excellent written and verbal communication skills. Proficiency in Microsoft Office Suite, particularly Excel and Word. Ability to work independently and manage multiple tasks simultaneously. Knowledge of healthcare insurance and stop loss policies is preferred. Medical billing experience a plus. Experience with David Young system a plus What We Offer: We're proud to offer a competitive salary, PTO & paid holidays, 401(k) with match, exclusive discount programs, health & wellness programs, and more. Our PeopleFirst culture focuses on building and nurturing lifelong relationships with our employees because, at the end of the day, we exist to be there for others. The base salary range for this position is $50,000 to $65,000. The base salary offered will be determined by factors including, but not limited to, experience, credentials, education, certifications, skill level required for the position, the scope of the position, and geographic location. Actual base salary offered will be determined on a case-by-case basis. In addition to the base salary, this position may be eligible for performance-based incentives. NFP and You... Better Together! NFP is an inclusive Equal Employment Opportunity employer.

We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, this specific role could have the flexibility to work from home up to 5 days per week. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated and experienced field claims professional to join our team. This job handles insurance claims in the field under general supervision through the life-cycle of a claim including but not limited to: investigation, evaluation, and claim resolution. This job provides service to agents, insureds, and others to ensure claims resolve accurately and timely. This job requires mastery of claims-handling skills and requires the person to: Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability Handle multi-line property and casualty claims in an assigned territory with an emphasis on property claims Become familiar with insurance coverage by studying insurance policies, endorsements and forms Work toward the resolution of claims, and attend arbitrations, mediations, depositions, or trials as necessary Ensure that claims payments are issued in a timely and accurate manner Handle investigations by phone, mail and on-site investigations Desired Skills & Experience Bachelor's degree or direct equivalent experience handling property and casualty claims A minimum of 3 years handling multi-line property and casualty claims with an emphasis on property claims Field claims handling experience is preferred but not required Knowledge of Xactimate software is preferred but not required Above average communication skills (written and verbal) Ability to resolve complex issues Organize and interpret data Ability to handle multiple assignments Ability to effectively deal with a diverse group individuals Ability to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents) Ability to drive an automobile, possess a valid driver license, and maintain a driving record consistent with the Company's underwriting guidelines for coverage 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#IN-DNI

Who Are We? Join our team to take what you love about working in the insurance industry to a whole new level. Serve people all over the country through hundreds of agencies by helping our clients do what they do best. Angela Adams Consulting is the premier resource for agencies providing advice, custom solutions, and remote services related to front and back-office insurance agency operations. Our Consultants, Trainers, Account Managers, Processors, and Insurance Specialists are the most elite professionals in the industry. Become part of a team that truly values collaboration, innovation, and shining the light to success for all independent insurance agencies. Our work schedule is flexible, and most employees work from the comfort of home and enables them to enjoy work and a personal life. We provide Extensive job training, and our Lighthouse Academy is available to all employees - providing an abundance of opportunity for professional growth in a variety of areas. Description To process accounting work as assigned by the account managers, and Direct Bill Lead, in a timely accurate and efficient manner. Duties Enter or reconcile direct bill statements Reconcile company statements Reconcile bank accounts Enter vendor checks Apply credit balances Post cash receipts Keep accurate record of time spent on each task Report inconsistencies to account manager Requirements One year insurance experience - preferred Prior bookkeeping experience - preferred Microsoft Office experience - required Self-motivated Detail oriented Benefits · Health Insurance · Paid time off · Dental Insurance · Vision Insurance · Life Insurance · 401(k) plan with matching Salary Description $15-$19 per hour

Spectraforce is a leading global services firm that provides a portfolio of consulting, staffing and outsourcing services and solutions to a broad range of clients and industries worldwide. We are headquartered in Raleigh, NC, USA. Job Description Title: Claims Clerk I Location : Columbia, South Carolina, 29203 Duration: 12 months Shift: Mon-Fri 8:00-4:30 and Mon-Fri 11:30-8:00pm Note: Training will be for at least 2 weeks on a Mon-Fri 8:30-5:00PM Qualifications Screen, code and key claims in claims system. Ensure claims are processed in a timely manner. 80% Screen, code and key claims to ensure proper and accurate adjudication of claims in accordance with departmental standards for quality and production, contract regulations, policies and guidelines. 1 0% Correct keying errors as noted by system edits. 10% Accurately use medical review forms and all available reference materials. Skills: Required Skills and Abilities: Strong organizational and analytical skills. Strong verbal and written communication skills. Ability to handle confidential or sensitive information with discretion. Required Software and Tools: Standard office equipment. Preferred Skills and Abilities: Ability to accurately key 5000 ksph or 30 wpm Preferred Software and Other Tools: Intermediate in word processing, spreadsheet application, and database software. Work Environment: Typical office environment. Education: Required Education: High School Diploma or equivalent Required Experience: None Additional Information All your information will be kept confidential according to EEO guidelines.

Your Career Begins at Timken If you're ready for a challenging career that provides you with the ability to advance personally and professionally, look to Timken. Our associates make the world more productive by improving the efficiency and reliability of the machinery that keeps industry in motion. Compensation Details: Starting Hourly Pay Rate: $15.00 per hour Full Range of benefits Paid Vacation, Paid Holidays Position Summary: Timken Distribution Center is currently seeking 2nd Shift Package Processors for its facility located in Duncan, SC. Work schedule 3pm-11pm Monday through Friday, plus overtime as scheduled. A successful warehouse employee values safety, accuracy, productivity, and customer service. Essential Job Duties: * Use hand-held scanner to scan and sort product by part number and to create and print Delivery Note (DN.) * Verify correct components such as parts, part numbers, quantities, and other specifications against DN. * Follow customer specific instructions from Pack Manual and/or DN to pack material into appropriate shipping containers, including required dunnage and labels/label placement. * Must be able to know, understand and follow Pack (PK) codes, Global Packaging Records (GPRs,) and pack diagrams. * Must be able to recognize when customer orders carry special instructions and pack to those specifications. * Must have basic computer skills in order to access and follow online Pack Manual for other required instructions. * Upon completion of packaging, must reverify part number, quantity, and other specifications against DN. * Apply all labels and ensure proper placement as required by the customer. * Use available resources to determine product for customer and packing instructions. Minimum Requirements: * 18 years of age. * High school diploma or general education degree (GED) required. Language Skills: * Ability to read and interpret documents such as safety rules, work instructions and procedure manuals. Ability to complete production forms. Ability to communicate effectively with co-workers and plant leadership. Physical Demands: * While performing the duties of this job, the employee is frequently required to stand, walk, bend, stoop, crouch and use hands/arms. The employee is regularly required to talk, hear at conversational level. The employee must regularly lift/move up to 30 pounds, frequently lift/move up to 40 pounds, and occasionally lift/move up to 55 pounds. Moving/lifting greater than 55 pounds requires assistance from another employee or a lifting device/hoist. Specific vision abilities required by this job include close vision, peripheral vision, depth perception, and ability to adjust focus. Required Personal Protective Equipment: * Employee is required to wear steel-toed shoes at all times while on the plant floor. You should be proficient in: * Experience in a Manufacturing Environment * Meets Physical Requirements * Packaging Experience All qualified applicants shall be treated equally according to their individual qualifications, abilities, experiences and other employment standards. There will be no discrimination due to gender or gender identity, race, religion, color, national origin, ancestry, age, disability, sexual orientation, veteran/military status or any other basis protected by applicable law.