Appeals Specialists

BlueCross BlueShield of South CarolinaColumbia, SC
Onsite

About The Position

Performs non-medical reviews and processes redetermination letters. Logistics: Palmetto GBA - one of BlueCross BlueShield's South Carolina subsidiary companies. This position is full time (40 hours/week) Monday–Friday, 8:00 AM – 5:00 PM. The role is 100% onsite and candidates may be located at either of the following locations: Florence: 200 Dozier Blvd, Florence, SC 29501 Columbia: Government Programs Complex (GPC), 17 Technology Circle, Columbia, SC 29203 Please include an updated resume with your application.

Requirements

  • High School Diploma or equivalent
  • 2 years job related field experience
  • Demonstrate 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
  • Microsoft Office skills

Nice To Haves

  • Medicare Part B work experience.
  • Excellent written communication skills.
  • Good oral communication skills.

Responsibilities

  • Perform non-medical reviews and process redetermination letters ensuring timeliness and accuracy.
  • Prepare unit reports, analyze and interpret workload, and process issues utilizing various software tools.
  • Update letters and documents within the department when necessary.
  • May gather and prepare documentation for legal inquiries and administrative requests.

Benefits

  • 401(k) retirement savings plan with company match.
  • Subsidized health plans and free vision coverage.
  • Life insurance.
  • Paid annual leave – the longer you work here, the more you earn.
  • Nine paid holidays.
  • On-site cafeterias and fitness centers in major locations.
  • Wellness programs and healthy lifestyle premium discount.
  • Tuition assistance.
  • Service recognition.
  • Incentive Plan.
  • Merit Plan.
  • Continuing education funds for additional certifications and certification renewal.
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