Job ID: 50655
Location: Columbia, South Carolina
Employment Type: Contract
Last Updated: 8 days ago
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Our client is looking to add a Claims Processor to their team. This position will be responsible for determining and updating eligibility for individuals and families, following state and federal policies. This includes reviewing applications, collecting documentation, and ensuring accurate and timely decisions.

Key Responsibilities:
  • Review applications and documents to determine eligibility.
  • Use internal systems and tools to verify applicant information.
  • Request and follow up on any missing information from applicants.
  • Accurately document all actions and decisions in the system.
  • Follow department procedures and escalate complex cases when needed.
  • Communicate clearly and professionally with applicants and coworkers.
  • Maintain confidentiality and follow privacy policies.
  • Attend required trainings and maintain certifications.
  • Perform other related duties as assigned.

Minimum Requirements:
  • High school diploma plus relevant experience in customer service, social services, or Medicaid processing OR a bachelor’s degree (can substitute for experience)

Preferred Qualifications:
  • Strong computer and Microsoft Office skills.
  • Clear communication skills (written and verbal).
  • Customer service experience in a professional setting.
  • Ability to learn and apply Medicaid eligibility rules.
  • Organized, detail-oriented, and able to manage time effectively.
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