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Hcsc Claim Jobs (NOW HIRING)

HCSC Group

Includes BPO vendor, Pharmacy Claim vendor (Express Scripts), and internal HCSC Business and matrix partners. * Perform ongoing review and interpretation of new and existing CMS requirements to ...

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Luminare Health

Sr Claims Analyst

$18.07 - $33.92/hr

Job Summary This position includes a variety of claim administrative and technical tasks that ... If so, ask your connection at HCSC about our Employee Referral process! EEO Statement: We are an ...

Health Care Service Corporation

Sr Claims Analyst

$18.07 - $33.92/hr

Job Summary This position includes a variety of claim administrative and technical tasks that ... If so, ask your connection at HCSC about our Employee Referral process! EEO Statement: We are an ...

Luminare Health

Sr Claims Analyst - LHB

Job Summary This position includes a variety of claim administrative and technical tasks that ... If so, ask your connection at HCSC about our Employee Referral process! EEO Statement: We are an ...

Luminare Health

Sr Claims Analyst - LHB

Job Summary This position includes a variety of claim administrative and technical tasks that ... If so, ask your connection at HCSC about our Employee Referral process! EEO Statement: We are an ...

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Hcsc Claim information

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$13

$21

$28

How much do hcsc claim jobs pay per hour?

As of Sep 12, 2026, the average hourly pay for hcsc claim in the United States is $21.05, according to ZipRecruiter salary data. Most workers in this role earn between $18.03 and $22.84 per hour, depending on experience, location, and employer.

What are HCSC claims?

HCSC claims refer to insurance claims that are processed by the Health Care Service Corporation (HCSC), which operates several Blue Cross and Blue Shield insurance plans. These claims are submitted by healthcare providers or policyholders to request payment for covered medical services. The process includes submitting necessary documentation, claims review, and adjudication to determine eligibility and reimbursement. Efficient and accurate processing of HCSC claims ensures that members receive the benefits they are entitled to under their insurance plans.

What are some common challenges faced by HCSC claim professionals, and how can they be addressed?

HCSC Claim professionals often encounter challenges such as navigating complex insurance policies, managing high volumes of claims, and ensuring timely, accurate processing. They may also need to handle difficult conversations with providers or members regarding claim denials or adjustments. To address these challenges, it’s important to stay current on policy updates, utilize available claims management systems efficiently, and develop strong communication and problem-solving skills. Support from experienced colleagues and ongoing training can also help professionals thrive in this fast-paced environment.

What are the key skills and qualifications needed to thrive as an HCSC claims processor, and why are they important?

To thrive as an HCSC Claims Processor, you need strong analytical abilities, attention to detail, and a solid understanding of insurance policies, typically supported by a high school diploma or equivalent. Familiarity with claims processing systems, medical billing software, and Microsoft Office Suite is commonly required. Excellent communication, organizational skills, and the ability to handle confidential information with integrity help individuals excel in this role. These competencies ensure accurate claims adjudication, compliance with regulations, and high-quality customer service for members and providers.

What is the difference between Hcsc Claim vs Hcsc Coordinator?

AspectHcsc ClaimHcsc Coordinator
CredentialsMedical billing certifications, knowledge of insurance policiesHealthcare administration certifications, communication skills
Work EnvironmentMedical offices, insurance companiesHospitals, clinics, healthcare facilities
Employer & IndustryHealth insurance providers, healthcare organizationsHospitals, healthcare networks
Search & ComparisonOften compared for billing and claims processing rolesRelated but focuses on coordination and administrative tasks

Hcsc Claim primarily handles billing, claims submission, and insurance reimbursements, requiring billing certifications and insurance knowledge. Hcsc Coordinator focuses on administrative coordination within healthcare settings, emphasizing communication and organizational skills. While both roles are integral to healthcare operations, they differ in responsibilities and work environments.

What are popular job titles related to Hcsc Claim jobs?

For Hcsc Claim jobs, the most frequently searched job titles are:

Claim Technician

Albuquerque, NM • Hybrid

Health Care Service Corporation
Outpatient Health Care • 10K+ employees
Learn more about Health Care Service Corporationexternal

$17.75 - $18.25/hr

Full-time

Medical, Life, Retirement, PTO

Posted 10 days ago

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job SummaryBASIC FUNCTION
Under supervision, this position is responsible for processing complex claims requiring further investigation, including coordination of benefits and resolving pended claims. The Claim Technician is responsible for reviewing, processing, and adjudicating healthcare claims accurately and efficiently in accordance with company policies, payer guidelines, and regulatory requirements. This role investigates claim discrepancies, researches denials, verifies member and provider information, and ensures timely claim resolution. The Claims Technician also collaborates with internal departments, providers, and members to resolve claim issues while maintaining high standards of accuracy, productivity, compliance, and customer service. The ideal candidate demonstrates strong analytical skills, attention to detail, and knowledge of healthcare claims processing, medical terminology, and applicable regulations, including HIPAA. Starting pay falls between: $17.75 to $18.25, commensurate with experience
NOTE: there is a mandatory six-week onsite training with strict attendance requirements which occurs Monday-Friday (8am to 5pm). Upon successful completion of this training, work from home provisions will be established.

JOB REQUIREMENTS

  • High School diploma or GED.
  • Solid data entry and/or typing experience.
  • Proficiency in Microsoft Office Suite, including Excel for data review and reporting.
  • Clear and concise written and verbal communication skills.
  • Experience processing medical claims with the ability to manage high-volume workloads while maintaining quality metrics.
  • Strong attention to detail, problem-solving, and organizational skills.

PREFERRED REQUIREMENTS

  • Must have trained on the six or eight-week Blue Chip claims processing system or have the ability to fully complete the six or eight-week Blue Chip Training class.
  • Knowledge of medical terminology and CPT, HCPCS, and ICD9 coding.
  • Knowledge of coordination of benefits principles and terminology.
  • Familiarity with claims adjudication systems and healthcare payer processes.
  • Experience with multi-tasking and prioritizing.

~ KEY FUNCTIONS ~

  • Process complex claims in various queues. Conduct research and investigation into missing information, make phone calls to providers (as necessary), access resource materials and support files in order to process and adjudicate claims timely and accurately.
  • Resolve complex pended claims, duplicate claims and adjustments.
  • Process claims, involving communications with participating plans and/or Service Units. Resolve various issues.
  • Research and identify other insurance, Medicare, Medicaid and update patient file as needed.
  • Coordinate benefits; request explanation of benefits as needed.
  • Maintain a working understanding of medical terminology and CPT, HCPCS, and ICD9 coding.
  • Maintain knowledge related to specific contracts.
  • Read appropriate files in IMAGE and apply information to claims as needed using the Financial Suspense System (FSS).
  • Learn and maintain knowledge of DOL ERISA and prompt pay legislation.
  • Periodic overtime may be required at the sole discretion of the employer based on business need.

NOTE: there is a mandatory six-week onsite training with strict attendance requirements which occurs Monday-Friday (8am to 5pm). Upon successful completion of this training, work from home provisions will be established.

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plansubject to the terms and the conditions of the plan.

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range$17.75 - $26.17

Exact compensation may vary based on skills, experience, and location.

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