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Insurance Claims Processing Jobs in South Carolina

MUSC

Claims Processor II

Orangeburg, SC · On-site

$16.25 - $20.50/hr

Summary 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 ...

New

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Claims Processor II

Columbia, SC

$15.75 - $20/hr

Ensures that claims are processing according to established quality and production standards ... Life Insurance * Paid Time Off (PTO) * On-site cafeterias and fitness centers in major locations

New

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Claims Processor II

Columbia, SC

$15.75 - $20/hr

Ensures that claims are processing according to established quality and production standards ... Life Insurance * Paid Time Off (PTO) * On-site cafeterias and fitness centers in major locations

New

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Claims Processor I

Myrtle Beach, SC · On-site

$15.25 - $19.25/hr

Summary Responsible for the accurate and timely processing of claims. Description Logistics: PGBA ... Employees will receive supplemental pay for health insurance until they are enrolled in our health ...

Ourhrconnect

Claims Processor I

Myrtle Beach, SC

$15.25 - $19.25/hr

Summary Responsible for the accurate and timely processing of claims. Description Logistics: PGBA ... Employees will receive supplemental pay for health insurance until they are enrolled in our health ...

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Processor, Claims I

Myrtle Beach, SC · On-site

$15.25 - $19.25/hr

Summary Responsible for the accurate and timely processing of claims. Description Logistics: PGBA ... Employees will receive supplemental pay for health insurance until they are enrolled in our health ...

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All JobsInsurance Claims Processing JobsInsurance Claims Processing Jobs in South Carolina

Insurance Claims Processing information

What is insurance claims processing?

Insurance claims processing is the procedure by which insurance companies review, investigate, and settle claims made by policyholders. This process involves verifying the details of a claim, ensuring it meets the terms of the policy, and determining the appropriate payout or action. Claims processors handle documentation, communicate with claimants, and may work with other parties like adjusters or healthcare providers. The goal is to ensure claims are resolved efficiently, accurately, and fairly according to policy guidelines.

What are the key skills and qualifications needed to thrive in insurance claims processing?

To excel in Insurance Claims Processing, you need strong attention to detail, analytical abilities, and a foundational understanding of insurance policies or claims procedures, often supported by a high school diploma or associate degree. Familiarity with claims management software, databases, and sometimes industry certifications like AIC (Associate in Claims) is common. Effective communication, problem-solving skills, and the ability to manage stressful situations make someone stand out in this role. These competencies are critical for ensuring claims are processed accurately, efficiently, and in compliance with regulatory standards.

What are some common challenges faced in insurance claims processing, and how can new team members effectively manage them?

In insurance claims processing, new team members often encounter challenges such as handling high volumes of claims, interpreting complex policy language, and communicating effectively with policyholders and other stakeholders. To manage these challenges, it's important to develop strong organizational skills, stay detail-oriented, and proactively seek clarification when unsure about policy terms or procedures. Collaborating with experienced colleagues and taking advantage of ongoing training opportunities can also help new processors build confidence and efficiency in their daily tasks.

What is the difference between Insurance Claims Processing vs Insurance Adjuster?

AspectInsurance Claims ProcessingInsurance Adjuster
CredentialsTypically requires a high school diploma or equivalent; certifications like CPCU or AIC are commonRequires a high school diploma; certifications like AIC or state licensing often needed
Work EnvironmentOffice-based, processing claims via computer systemsField and office work, inspecting damages and interviewing claimants
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, independent adjusting firms
Primary FocusReviewing and processing insurance claims efficientlyAssessing damages and determining claim validity and payout

While both roles are essential in the insurance industry, Insurance Claims Processing focuses on handling and managing claims paperwork, whereas Insurance Adjusters evaluate damages and determine claim settlements. Understanding these differences helps job seekers identify the right career path within the insurance sector.

How to get a job as an insurance claims processor?

To become an insurance claims processor, candidates typically need a high school diploma or equivalent, with some roles preferring postsecondary training in insurance or related fields. Relevant skills include attention to detail, communication, and familiarity with claims processing software. Gaining experience through internships or entry-level positions can improve job prospects, and some employers may require certification such as the Certified Claims Professional (CCP).

Is insurance claims processing a stressful job?

Insurance claims processing can be a stressful job due to tight deadlines, high workload, and the need for accuracy in evaluating claims. It often requires strong attention to detail, communication skills, and the ability to handle difficult customer interactions, which can contribute to job-related stress.

What does an insurance claims processing do?

An insurance claims processor reviews and evaluates insurance claims to determine coverage eligibility and the amount payable. They verify information, process documentation, and communicate decisions to policyholders, often using claims management software. Attention to detail and knowledge of insurance policies are essential for this role.

What are popular job titles related to Insurance Claims Processing jobs in South Carolina?

For Insurance Claims Processing jobs in South Carolina, the most frequently searched job titles are:

What job categories do people searching Insurance Claims Processing jobs in South Carolina look for?

The top searched job categories for Insurance Claims Processing jobs in South Carolina are:

What cities in South Carolina are hiring for Insurance Claims Processing jobs?

Cities in South Carolina with the most Insurance Claims Processing job openings:

Insurance Claims Processing jobs near you
Infographic showing various Insurance Claims Processing job openings in South Carolina as of August 2026, with employment types broken down into 1% As Needed, 75% Full Time, 19% Part Time, and 5% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution.

Claims Processor II

Medical University of South Carolina

Orangeburg, SC

Full-time

Posted 2 days ago

New

Job description

Job Description Summary

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-21

Scheduled Weekly Hours

40

Work Shift

Job Description


Job Purpose

  • 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.

Education and Work Experience

  • Able to prioritize work on a daily basis. Requires independent judgement in handling patient accounts. Direct supervision available on a daily basis as conditions may require.
  • High school diploma required. One year of billing and insurance follow up in a hospital or physician office setting preferred. General working knowledge of insurance terminology and billing rules. Knowledge of Epic preferred.

Licensures, Registrations, Certifications

N/A

Physical Requirements

Continuous requirements are to perform job functions while standing, walking and sitting. Ability to bend at the waist, kneel, climb stairs, reach in all directions, fully use both hands and legs, possesses good finger dexterity, perform repetitive motions with hands/writs/elbows and shoulders, reach in all directions. Maintain 20/40 vision corrected, see and recognize objects close at hand and at a distance, work in a latex safe environment and work indoors. Frequently lift and/or carry objects weighing 20 lbs. (=/-) unassisted. Lift from 36" to overhead 15 lbs. Infrequently work in dusty areas and confined/cramped spaces.

Job Duties

Claims Processor II

  • 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

Able to prioritize work on a daily basis. Requires independent judgement in handling patient accounts. Direct supervision available on a daily basis as conditions may require.

Associates Degree preferred with 2 years billing and insurance follow up or 4 years of billing and insurance follow up in a hospital or physician office setting required. Thorough working knowledge of insurance terminology, CPT coding and billing rules required. Knowledge of Epic preferred.

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: http://www.uscis.gov/e-verify/employees

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