271 Results for

Claims Specialist Jobs in South Carolina

Jobs

Columbia, SC16 days ago

$35,000–$45,000 Per Year

Provides prompt customer service to policy holders, providers and other internal company entities regarding claims; documents phone calls in the system and follows-up on issues if needed; contacts insured or other appropriate persons to verify the accuracy and completeness of information on claims forms and related documents, responds to inquiries from policy holders, providers, agents regarding claim status and policy provisions. Provides back-up coverage for other teams as required, maintains databases and prepares and extracts information using software systems; performs various clerical duties as assigned, such as filing, photocopying, typing, maintaining databases and preparing and extracting information using software systems.

Usa, South Carolina13 days ago

Remote

ServiceMac is focused on providing superior technology, products, and services for the mortgage and real estate industries backed by highly personalized service and support. Completes claim and title activities by interacting and instructing various parties such as attorneys, investors, insurers, and any other party involved with the claim.

Fort Mill, SC30+ days ago

Remote

ServiceMac is focused on providing superior technology, products, and services for the mortgage and real estate industries backed by highly personalized service and support. WHAT YOULL DO Responsible for servicing mortgage accounts to ensure title and claim activities are processed in compliance with all state and federal laws while maintaining compliance with Investor, Insurer, Agency and company guidelines.

SC11 days ago

Remote

$137,496–$164,934 Per Year

Boston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area, including but limited to Albany county), Washington, D. C. Essential Responsibilities: Working under limited oversight under broad management direction, adjudicate construction defect claims at the highest authority limits on assignments reflecting the highest degree of technical complexity, potentially with major impact on departmental results.

Greenville, SC30+ days ago

Key Skills: • Basic working knowledge and familiarity of: • Commercial General Liability • Property Insurance (Including Inland Marine and Builder's Risk) • Pollution Liability • Professional Liability • Controlled Insurance Programs (CCIP/OCIP) • RMIS Systems • Construction Industry Expertise • Strategic thinking • Strong written and oral communication skills • High level of EQ (Soft skills) • Self-Starter • Highly organized and responsive; ability to meet deadlines • Detail Oriented • Contractual risk assessment • Dispute management • Integrity • Ability to mentor and inspire others • Team player • Willingness to understand and advance the DPR Culture • Proactive Learner. Act as a liaison between all parties involved, including but not limited to, carriers, clients, trade partners, brokers, consultants, attorneys and DPR project teams (and DPR-related entities), as it relates to claim progress, strategy, expenses, and settlements.

Columbia, South Carolina9 days ago

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. Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs.

Greer, South Carolina10 days ago

Our goal is to ensure an industry leading customer experience at every point of the claims process by facilitating the ease of doing business and driving customer retention through prompt post-fulfillment claim mitigation and resolution. Maddox is the nation’s leading provider of electrical transformers to the commercial and industrial market, with primary locations in South Carolina, Washington State, Texas, Idaho, and Ohio.

Work At Home, SC9 days ago

$18.50–$42.35 Per Hour

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. 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.

Anderson, SC30+ days ago

Located in the heart ofAnderson, South Carolina,AnMedis a dynamic, not-for-profit health system dedicated to delivering exceptional care with compassion, innovation, and integrity. Whether youre just starting your career or looking to grow in a new direction, youll find opportunities to thrive, lead, and make a meaningful impact here.

New!

Columbia, South Carolina5 days ago

$59,059.65–$90,000 Per Year

Competitive candidates should reside within one of the listed zip codes and will service this same territory: 29006 29009 29014 29015 29016 29020 29032 29036 29037 29045 29054 29063 29065 29070 29072 29073 29074 29075 29078 29101 29105 29108 29122 29123 29126 29127 29129 29130 29138 29143 29145 29164 29166 29169 29170 29175 29180 29203 29204 29208 29210 29212 29223 29229 29355 29666 29718 29727 29728 29805 29832. With the opportunity to initially earn up to 20 days annually plus parental leave, paid holidays, celebration day, life leave (40 hours/year), bereavement leave, and community service/education support days, there will be plenty of time for you!

SC20 days ago

By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals.

Columbia, SC30+ days ago

$62,500–$115,500 Per Year

Nationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. In this role, you'll conduct on-site inspections, evaluate property damages, determine policy coverage, and make timely, accurate decisions using a variety of tools and resources, including vendor estimates, independent adjusters, and self-written assessments.

Fort Mill, SC30+ days ago

This position will be responsible for processing a pipeline of Insurance Claims while maintaining the quality and accuracy of the claims package focusing on the customer borrower investor payee and internal customer experience with loans under service with RoundPoint Mortgage Servicing ensuring that all property with claimed damages is repaired properly in accordance with any agency and/or investor guidelines. We leverage our core competencies of understanding and managing interest rate and prepayment risk to invest in our Agency residential mortgage-backed securities (RMBS) and mortgage servicing rights (MSR) portfolio with the objective of delivering attractive risk-adjusted returns to our stockholders.

Work At Home, SC17 days ago

$17–$28.46 Per Hour

Analyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department. Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing.

Charleston, SC13 days ago

contributory) and assess likelihood of recovery; Develop supervisor-escalation scenarios that test whether the agent correctly recognizes authority-limit thresholds ($25,000) and stops short of auto-approving; Draft and evaluate reservation-of-rights letter scenarios, verifying language stays within the bad-faith line; Validate coverage-limits math when multiple endorsements (OEM, rideshare, extended rental) stack on a single claim; Document test cases clearly with correct answers, policy citations, and payout calculations. Ideally, contributors will have: Degree in Finance, Business, Insurance, or related field — or equivalent professional experience; no specific degree is required if AIC, CPCU, or comparable credentials are present, or if the candidate has 4+ years of hands-on claims adjusting experience; 3+ years of hands-on auto claims adjusting, examining, or supervisory experience at a U.S. carrier, independent adjusting firm, or SIU team; Ability to make coverage decisions (collision vs.

Charleston, SC30+ days ago

Remote

Full-time

Proficient with claim and coding tools such as Supercoder, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding. This role will serve as a SME and will collaborate with Claims leadership, Training, the Claims Content Specialist, and internal business partners to ensure procedures and training materials are accurate and complete.

SC30+ days ago

$66,330–$145,860 Per Year

Directs work flow to ensure the efficient and accurate processing of medical claims by establishing and monitoring productivity and quality metrics, managing and developing a team of claims support individuals, implementing process improvement initiatives, and fostering collaboration with internal and external stakeholders to optimize claim processing, minimize errors, and enhance overall operational effectiveness and customer satisfaction. Assists with the development of the claim processing budget by monitoring expenses, tracking budget variances, and identifying cost-saving opportunities while maintaining operational effectiveness and service quality.

New!

SC6 days ago

$15–$20 Per Hour

By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. This position also provides support to CR1 staff during periods of high volume, which includes compiling claim packets and referring eligible claims with supporting documentation to collection vendors, excluding claims involving total losses.

Columbia, SC30+ days ago

Remote

As the IT Healthcare Consultant – Business Analyst – Advanced (Clinical Analyst and Coding Specialist): Specific duties include, but are not limited to: Initiates annual (and quarterly) updates from CMS of all ICD-10, CPT/HCPCS coding changes. Client is seeking This project is a multi-year effort which primarily focuses on providing consulting services to operations and policy staff for the current Medicaid Management Information System.

Greenville, South Carolina30+ days ago

In this role, you’ll manage the full billing cycle, handle insurance claims and patient inquiries, and ensure timely payment collection—all while keeping things running smoothly behind the scenes. Company Story: Medical Billing Center is a Physical Therapist-led company focused on helping healthcare providers thrive through streamlined billing and collections.

Charleston, South Carolina12 days ago

Assist with the collections of receivables for guarantor and any third-party payers by monitoring accounts receivables, checking claim status and resubmitting claims of overdue accounts, filing corrected claims or appeals and alerting supervisor of seriously overdue accounts and trends. The College of Dental Medicine (CDM) MUSC billing team member will manage collection issues with CDM Leadership, resolve issues, apply new information to future collection issues, and make suggestions to enhance our efficiency and effectiveness through process improvement.

Charleston, South Carolina11 days ago

Greenville, South Carolina23 days ago

Remote

Utilize and apply industry knowledge to resolve new and aged accounts receivables by working various account types, including but not limited to professional claims, governmental and/or non-governmental claims, denied claims, aged accounts, high priority accounts, high dollar accounts, reimbursements, credits, etc. Crossroads is a family of professionals dedicated to providing the most accessible, highest quality, evidence-based medication assisted treatment (MAT) options to combat the growing opioid epidemic and helping people with opioid use disorder start their path to recovery.

Spartanburg, SC30+ days ago

As a regional leader in hospice and palliative care, Agape Care Group proudly serves patients through its family of care providers - Agape Care South Carolina, Georgia Hospice Care, Hospice of the Carolina Foothills in North Carolina, and ACG Hospice in Alabama, Kansas, Louisiana, Missouri, Oklahoma, and Virginia. Must be discreet and maintain HIPAA and confidentiality in the workplace TRANSPORTATION: Reliable Transportation - IN OFFICE ROLE - 187 North Church St. Suite 201 Spartanburg, SC 29306 HEALTH STATUS: Meets all applicable agency policies and procedures related to health screening and required testing.

Spartanburg, SC30+ days ago

Remote

The Collections Specialist is responsible for managing and collecting on accounts receivables for all insurance carrier plan services billed through the hospital/physician billing systems. Possess an in-depth working knowledge and experience with all types of insurance billing guidelines: Commercial, Medicare Part A and B, Medicaid, Managed Care plans etc.

Greenville, South Carolina30+ days ago

Assists patients in completing all necessary forms to obtain hospitalization or Surgical precertification from insurance companies, including waivers for cases where pre-certification is required but not yet obtained. In lieu of education and experience noted above, an equivalent combination of work/academic experience may be considered (i.e., four years related work experience or Bachelor's degree in Healthcare or Business).

Columbia, SC30+ days ago

Remote

InterSources Inc , is a Small, Woman, and Minority-Owned Business Enterprise, ISO/IEC 27001, SOC 2 Type 2 certified company with massive 18+ years of diversified experience in providing IT Consulting Services, Artificial Intelligence, Data Analysis, Application Development, Cloud Services, Cybersecurity, Digital Marketing, ERP Management, Custom Software Development, Web Development, UI/ UX Design, System Integration, QA Support etc. Job Title: IT Healthcare Consultant – Business Analyst - Advanced (Clinical Analyst & Coding Specialist) (11013).

Aiken, SC20 days ago

Under the direction of the RMCM our medical coding & billing specialist's daily duties will include maintaining billing software, appealing denied claims, and recording payment, claims follow up, and denial resolution. Essential Functions/Responsibilities: Processes billings to patients and third-party reimbursement claims; maintains supporting documentation files and current patient addresses.

Charleston, SC30+ days ago

Remote

For ambulatory surgery centers (ASCs), SIS provides comprehensive software and services, including ASC management, electronic health records (EHRs), patient engagement capabilities, compliance technology, and revenue cycle management and transcription services, all built specifically for ASCs. Recognized as the No. 1 ASC EHR vendor by Black Book for 11 consecutive years and honored with the Best in KLAS Award for ASC Solutions in 2026, 2025, 2023, and 2022, SIS remains the trusted choice for surgical providers seeking to enhance their performance.

Spartanburg, SC18 days ago

Lead continuous improvement initiatives, including network redesigns, route optimization, and cost-saving opportunities-especially during product launch phases. This is where intelligent solutions for the automotive world are born-and where we, as a partner, provide answers on central topics like safety, the environment, and efficiency to nearly every major automotive manufacturer.

Summerville, SC12 days ago

This position plays a key role in managing the billing cycle, ensuring timely and accurate posting of payments, resolving claim denials, and maintaining strong relationships with both patients and insurance carriers. Charleston GI has been developing since 1989, our practice is the first and largest gastroenterology practice in the Lowcountry to operate a physician's practice and three nationally certified and state licensed endoscopy centers.

Spartanburg, SC18 days ago

Responsible for all pre-bill edits and claim scrubber edits for accuracy and compliance with all government and commercial carriers billing guidelines before releasing for submission to payers. Exhibit good professional communication and customer service skills at all times while working with coworkers and employees in multiple departments within the system.

Spartanburg, SC30+ days ago

Remote

Only Applicants from the following states: Alabama, Arizona, Connecticut, Delaware, Florida, Georgia, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, North Carolina, Pennsylvania, Rhode Island, South Carolina, Virginia, West Virginia, Wisconsin. Possess an in-depth working knowledge and experience with all types of insurance billing guidelines: Commercial, Medicare Part A and B, Medicaid, Managed Care plans etc.

Spartanburg, SC12 days ago

Remote

Columbia, South Carolina30+ days ago

This role requires a keen attention to detail, knowledge of medical billing best practices, and the ability to work collaboratively across departments to resolve claim issues and improve reimbursement outcomes. The Medical Billing specialist is responsible for working all aspects of the billing cycle, specifically in Accounts receivable, payment posting, denials, appeals, etc.

Conway, SC30+ days ago

Each employee who participates in the coding, billing or claims submission process, from the initial receipt of a physician order to the receipt of payment for services, shall accurately and honestly perform his/her functions to ensure that accurate claims are submitted, and the organization retains only those funds to which it is legally entitled. Position Summary:The Coding Specialist II (CS II) will use ICD and CPT and specialize in medical classification software to assign procedure and diagnosis codes for insurance billing for Conway Medical Center (CMC).QualificationsEducation:High school diploma required.

Conway, SC30+ days ago

Usa, South Carolina16 days ago

Process servicing functions related to Escrow from loan acquisition through life-of-loan servicing, including servicing transfers, mass escrow analysis processing, off-cycle analysis process and general escrow account maintenance. 2-5 years of experience working in a mortgage environment specific, preferably Mortgage Loan Servicing specific to escrow account activities (real estate taxes, property insurance, escrow analysis, mortgage insurance).

Charleston, SC30+ days ago

$17.26–$28.36 Per Hour

Take action in solving problems while exhibiting good judgment and a systematic approach to decision making; identify the important dimensions of a problem, determine potential causes, obtain relevant information, and specify alternate solutions that result in resolutions. QUALIFICATIONS for Specialist 06 (Account Specialist IV): High School Diploma or GED required supplemented with 5+ years of progressive experience in processing payroll for more than 500 employees, 941 forms, and working with State Retirement.

New!

Summerville, SC4 days ago

Charleston GI has been developing since 1989, our practice is the first and largest gastroenterology practice in the Lowcountry to operate a physicians practice and three nationally certified and state licensed endoscopy centers. This role supports both coding and billing functions and requires someone who can work efficiently, communicate professionally, and take ownership of claim accuracy from the start.

Charleston, SC30+ days ago

Our company is seeking a Field Property Adjuster Specialist to investigate, evaluate, negotiate, and resolve complex property insurance claims while ensuring regulatory compliance and delivering empathetic, member-focused service. This role follows a virtual-first adjusting model, leveraging advanced estimating technology, while also performing in-field inspections within an assigned territory.

Spartanburg, SC23 days ago

Remote

Responsible for research and resolution of all outstanding patient and insurance credit accounts, any additional A/R management research and account updates required to ensure claims are filed to the appropriate carrier or posted correctly. Work closely with other departments on revenue integrity issues including variance contract build issues, charging issues, A/R type issues and other items as define.

Mount Pleasant, SC30+ days ago

Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and Molina guidelines. Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related outside agencies to ensure that internal and/or regulatory timelines are met.

South Carolina, SC30+ days ago

Proactively measures training efforts to ensure the teams are progressing, as desired, and responds accordingly when additional training is required to ensure team member is properly equipped to perform said job responsibilities. The hospitals within McLeod Health include: McLeod Regional Medical Center, McLeod Health Dillon, McLeod Health Loris, McLeod Health Seacoast, McLeod Health Cheraw, McLeod Health Clarendon and McLeod Behavioral Health.

Lancaster, South Carolina30+ days ago

This includes leading safety and housekeeping efforts, developing health and safety systems and procedures, identifying hazards, conducting investigations and root cause analysis, managing workers’ compensation activities, completing audits and regulatory reporting, administering behavior-based safety programs, coordinating emergency response procedures, maintaining environmental permits and compliance, and partnering with regulatory agencies and auditors. Job Summary: Reporting to plant leadership, the successful candidate will be responsible for promoting and maintaining IKO safety goals and ensuring a safe work environment for all employees.

Columbia, SC30+ days ago

Graniteville, SC25 days ago

As a Fulfillment Resolution Specialist, you will manage shipping claims, investigate order discrepancies, and coordinate resolutions to ensure timely and accurate delivery of products to customers and distributors. Handle returns and credits related to damaged goods, shortages, invoicing errors, and incorrect shipments.

SC30+ days ago

$83,100–$120,360 Per Year

Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. Prepare cases for Medical Director Review ensuring that all pertinent information (i.e. case summary, contract information, internal and external responses, diagnosis, and CPT codes and descriptions) has been obtained during investigation and is presented as part of the case.

Charleston, South Carolina24 days ago

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Claims Specialist Jobs in South Carolina

Claims Specialist I Aflac Inc

Sr. Default Claims Specialist (remote) First American

Default Claims Specialist (remote) First American Financial Corp

Senior Construction Defect Technical Claims Specialist Argo Group International Holdings Inc

Insurance Claims Specialist (Construction Defects and Property Damage) DPR Construction Inc

Bodily Injury Claims Specialist Auto-Owners Insurance Company

Claims Specialist Maddox Industrial Transformer

Senior Claims Benefit Specialist CVS Health Corp

Billing Specialist - Audit/ Claims Review AnMed Health

Claim Specialist - Property Field Inspection State Farm

Regional Senior Casualty Claim Specialist - Litigation AAA Southern New England

Claims Adjuster II, Field Property - National Catastrophe Nationwide Mutual Insurance Co

Insurance Claim Specialist Two Harbors Investment Corp

Claim Benefit Specialist CVS Health Corp

Senior Auto Claims Adjuster - Freelance AI Trainer Mindrift

Sr Claims Reviewer TriWest Healthcare Alliance

Manager, Claim Processing CVS Health Corp

Temporary Subrogation Claim Support Processor AAA Southern New England

IT Healthcare Consultant - Business Analyst - Advanced - Clinical Analyst & Coding Specialist Datasoft Technologies

AR Specialist Medical Billing Center

UNIV - Dental Billing Specialist - College of Dental Medicine Medical University of South Carolina

UNIV - Dental Billing Specialist - College of Dental Medicine MUSC

Remote AR Specialist - Medical Billing Crossroads Treatment Centers

Billing Specialist Agape Care Group

Specialist-Collections II (remote) Spartanburg Regional Healthcare System

Clinic Office Specialist Sr. F/T Day Prisma Health

IT Healthcare Consultant Business Analyst - Advanced (Clinical Analyst & Coding Specialist InterSources Inc.

Medical Billing /Coding Specialist Rural Healthcare Services

Insurance AR Specialist - Remote Surgical Information Systems LLC

Transportation Specialist Benteler International AG

Accounts Receivable and Billing Specialist Charleston Gastroenterology Specialist P

Specialist-Insurance Billing Spartanburg Regional Healthcare System

Specialist-Sr Denials Management (Remote) Spartanburg Regional Healthcare System

Insurance Billing Specialist (Remote) Spartanburg Regional Healthcare System

Medical Billing Specialist Midlands Neurology and Pain Associates, P.A.

Coding Specialist II Conway Medical Center

CODING SPECIALIST II Conway Medical Center

Sr. Escrow Servicing Operations Specialist First American

Account Specialist II, III or IV Charleston County South Carolina

Medical Billing & Coding Specialist (GI Practice) Charleston Gastroenterology Specialist P

Property Adjuster Specialist Field - Charleston, SC Vensure Employer Services

Specialist-Revenue Management (Remote) Spartanburg Regional Healthcare System

Specialist, Appeals & Grievances (Must live in TX and Medicaid experience) Molina Healthcare Inc

Instructional Support Specialist - Hospital Billing McLeod Health

HSE Specialist IKO

Instructional Support Specialist - Single Billing Office McLeod Health

Fulfillment Resolution Specialist MAU Workforce Solutions

Appeals and Grievances Clinical Specialist Healthfirst

UNIV - Billing Specialist - College of Dental Medicine Medical University of South Carolina

UNIV - Billing Specialist - College of Dental Medicine MUSC

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