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Claims Processor I Pgba Jobs (NOW HIRING)

Processor, Claims I

Columbia, SC ยท On-site

$15.75 - $20/hr

Summary Responsible for the accurate and timely processing of claims. Description Logistics: Palmetto GBA - one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position ...

Position Summary Investigates and processes COB (Coordination of Benefits) COB claims, and completes all necessary steps needed for claims processing. Assists in customer service inquiries regarding ...

Processor, Claims I

Florence, SC ยท On-site

$16.50 - $20.75/hr

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 ...

Claims Processors

Denver, CO ยท On-site

$17.50 - $22.25/hr

Hand key paper claims activity that is loaded in KL i.e. Smart Data rejects Required * 3+ as a Claims Processor or similar position in either a doctor's office, healthcare clinic or other healthcare ...

Also processes adjustments related to overpayment recovery, underpayment adjustments and other ... Support Processor I designation may also be obtained through equivalent work experience and ...

Billing Processor I, II or CPC

Tucson, AZ ยท On-site

$17 - $22/hr

Review and process rejected claims, verify and work adjudicated claims, resolve and resubmit claims ... Essential Duties and Responsibilities (Billing Processor I, II and CPC): * Verifies member coverage ...

$65K - $85K/yr

Overview Nakupuna Consulting is seeking a detail-oriented Claims Examiner I to support a federal ... Experience in insurance, claims processing, legal support, or quality assurance environments is ...

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Claims Processor I Pgba information

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$12

$19

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How much do claims processor i pgba jobs pay per hour?

As of Jun 14, 2026, the average hourly pay for claims processor i pgba in the United States is $19.16, according to ZipRecruiter salary data. Most workers in this role earn between $16.35 and $20.67 per hour, depending on experience, location, and employer.

What is the difference between Claims Processor I Pgba vs Claims Processor II?

AspectClaims Processor I PgbaClaims Processor II
Required CredentialsHigh school diploma or equivalent; basic insurance knowledgeHigh school diploma; some experience or certification preferred
Work EnvironmentEntry-level, clerical setting within insurance companiesMore complex claims processing, possibly supervisory tasks
Employer & Industry UsageCommon in insurance companies, healthcare providersUsed in similar settings, often with increased responsibilities

The main difference between Claims Processor I Pgba and Claims Processor II lies in experience and responsibilities. Claims Processor II typically handles more complex claims and may assist or supervise Claims Processor I Pgba roles. Both positions require similar credentials but differ in scope and expertise.

What does a Claims Processor I PGBA do?

A Claims Processor I PGBA is responsible for reviewing, processing, and adjudicating insurance claims in accordance with company policies and industry regulations. They verify the accuracy of information, determine eligibility, and ensure claims are processed efficiently and correctly. This entry-level position often involves communicating with policyholders, healthcare providers, and other stakeholders to resolve discrepancies or gather additional information. Attention to detail and knowledge of insurance procedures are essential for success in this role.

What are the key skills and qualifications needed to thrive as a Claims Processor I PGBA, and why are they important?

To thrive as a Claims Processor I PGBA, you need strong attention to detail, analytical skills, and a high school diploma or equivalent. Familiarity with claims processing software, data entry systems, and knowledge of insurance or healthcare terminology are typically required. Exceptional organizational skills, time management, and effective communication set top performers apart. These abilities ensure accurate and timely processing of claims, reducing errors and supporting customer satisfaction in a high-volume environment.

What are some common challenges faced by a Claims Processor I at PGBA, and how can they be successfully managed?

Claims Processors at PGBA often encounter challenges such as high volumes of claims, strict accuracy requirements, and tight deadlines. Successfully managing these involves strong attention to detail, effective time management, and familiarity with claims processing software. Collaboration with team members and clear communication with supervisors can help resolve complex cases efficiently. Continuous learning about updated policies and procedures also plays a key role in overcoming daily obstacles.
More about Claims Processor I Pgba jobs
What cities are hiring for Claims Processor I Pgba jobs? Cities with the most Claims Processor I Pgba job openings:
What states have the most Claims Processor I Pgba jobs? States with the most job openings for Claims Processor I Pgba jobs include:
Infographic showing various Claims Processor I Pgba job openings in the United States as of June 2026, with employment types broken down into 100% Full Time. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $39,863 per year, or $19.2 per hour.

Processor, Claims I

Ourhrconnect

Columbia, SC โ€ข On-site

$15.75 - $20/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 6 days ago


Job description


Summary
ย Responsible for the accurate and timely processing of claims.
Description
ย 

Logistics: Palmetto GBA - one of BlueCross BlueShield's South Carolina subsidiary companies.

Location: This position is full-time (40-hours/week) Monday-Friday from 8:00am-5:00pm in a typical office environment. This role is located on-site at 17 Technology Cir, Columbia, SC 29203.

  • 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 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 disabilitiesand 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 mycareer.help@bcbssc.comor call 800-288-2227, 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 moreinformation.

Some states have required notifications. Here's more information.