Facebook · 6 hours ago
Claims Research Analyst
Columbia, South Carolina
Full-time
Hybrid
Mid Level
3+ years expFacebook, in partnership with BlueCross BlueShield of South Carolina, is looking for a Claims Research Analyst. The role involves conducting research to prevent the aging of claims and ensuring accurate processing, while also assisting with special projects as needed.
Computer Software
No H1B
Responsibilities
Verify disbursement requests to ensure the request is valid and appropriately documented
Research rejected, transition, and paid status claims for validity and escalate as appropriate
Use the various systems of the department/company to complete research and gain sufficient knowledge of the claims system and how it relates to other systems
May research claims to identify or validate fraud, waste or abuse
Monitor inventory reports to ensure claims are resolved accordingly
Provide documentation as requested for audit purposes
May provide written or telephone correspondence to resolve claims issues
Research claims as related to billing or crediting groups
Research claims to ensure the proper adjustments are made and groups receive credit or are billed appropriately
Qualification
Required
High School Diploma or equivalent
3 years of experience processing claims in a healthcare environment
2 years of experience with claims systems (can be concurrent)
In-depth knowledge of claims payment policies and refund policies
Knowledge of related claims software systems
Knowledge of medical terminology, CPT IV coding, ICD 9 diagnosis codes, or NCPDP coding as appropriate
Good analytical skills and the ability to retrieve and research automated reports
Good time management skills and adaptable to change
Good communication skills, both written and verbal
Standard office equipment
Preferred
Bachelor's degree-in Business, Computer Science, Healthcare Administration, or a related field
4 years-of related experience if lacking degree
Knowledge of processing systems - RMMS, CES, AMMS, ITS, SOND, INFO, third party recovery display, and ALGS
Excellent written and verbal communication skills
Knowledge of electronic data processing systems and procedures and their integration with the users
Ability to run reports using pre-set data retrieval applications, such as DB2 and EZTRIEVE Plus, to obtain information for research and analysis
Benefits
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
Company
The Facebook company is now Meta. Meta builds technologies that help people connect, find communities, and grow businesses.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Arunava Chatterjee
Executive Director of Ghost Black Operations & CEO & CTO
Shubhra Gupta
CEO
Recent News
Business Live
2025-11-03
2025-11-01
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