Appeal Coordinator
BlueCross BlueShield of South Carolina•Columbia, SC
•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.
Benefits
- Supplemental pay until enrolled in health benefits 28 days after hire date
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
