Appeals Specialists

CGS Administrators, LLCColumbia, SC
Onsite

About The Position

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. CGS Administrators provides a variety of services, under contracts with the Centers for Medicare and Medicaid Services (CMS) for beneficiaries, health care providers, and medical equipment suppliers in 33 states, supporting the needs of more than 20 million Medicare beneficiaries nationwide. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Want to work for a growing company with an innovative eye towards the future? Join us today!

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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