Appeals Specialist
BlueCross BlueShield of South Carolina•Columbia, SC
•Onsite
About The Position
An Appeals Specialist performs non-medical reviews and processes redetermination letters. This position is based on site at the 4101 Percival Road, Columbia, SC 29229 location. Work hours: 8:30 AM – 5:00 PM. This position is not eligible for sponsorship now or in the future.
Requirements
- High School Diploma or equivalent
- 2 years job related field.
- Demonstrated proficiency in word processing and spreadsheet software.
- Excellent organizational, customer service, and written and verbal communication skills.
- Good judgment skills.
- Proficiency in spelling, punctuation, and grammar skills.
- Microsoft Office.
Nice To Haves
- Experience using Cohere and Genesys applications, with the ability to navigate and utilize these systems effectively.
- Operational experience with pre-service and post service authorizations
- Ability to effectively utilize multiple systems and tools to support operational and member/provider service needs.
Responsibilities
- Performs non-medical reviews and processes redetermination letters ensuring timeliness and accuracy.
- Prepares unit reports, analyzes and interprets workload, and processes issues utilizing various software tools.
- Updates letters and documents within the department when necessary.
- May gather and prepare documentation for legal inquiries and administrative requests.
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
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
