Appeal Coordinator

BlueCross BlueShield of South Carolina • Columbia, SC

2d • Onsite

About The Position

Palmetto GBA is seeking a detail-oriented and organized Coordinator, Appeals to join our appeals processing team. In this role, you will serve as the frontline support for all incoming appeal requests — reviewing, triaging, and routing cases to ensure timely and accurate processing in accordance with CMS guidelines. If you thrive in a structured, fast-paced environment and take pride in accuracy and organization, we'd love to hear from you!

Requirements

• High School Diploma or equivalent
• 1 year of administrative support/clerical or job-related experience
• Demonstrated proficiency in word processing and spreadsheet software
• Effective organizational and customer service skills
• Good judgment skills
• Proficiency in spelling, punctuation, and grammar
• Demonstrated written and verbal communication skills
• Microsoft Office proficiency

Nice To Haves

• 3 years of experience in claims, customer service, or healthcare program management
• Ability to persuade, negotiate, or influence
• Knowledge of Microsoft Access or other database software

Responsibilities

• Research requests, enter appropriate data to identify case specifics, and build appeals cases in the system.
• Log requests to the appropriate functional area, generate letters, assemble files, order records, and obtain additional information as directed.
• Ensure quality control of all appeals on the appeals system, pend documents to be saved electronically, and prepare case files for review and/or further routing.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees