BlueCross and BlueShield of South Carolina

SummaryScreen code and key claims in claims system. Ensure claims are processed in a timely manner.DescriptionLogistics:This is a full time (40 HPW) position and our ideal candidate will work on-site at our Columbia SC location.What Youll Do:Screen code and key claims to ensure prope المزيد...

SummaryCare management interventions focus on improving care coordination and reducing the fragmentation of the services the recipients of care often experience especially when multiple health care providers and different care settings are involved. Taken collectively care management المزيد...

SummaryDescriptionWhy should you join the BlueCross BlueShield of South Carolina family of companies Other companies come and go but weve been part of the national landscape for more than seven decades with our roots firmly embedded in the South Carolina community. We are the largest المزيد...

SummaryProvides specialized knowledge and expertise in the design of compensation programs and practices. Collaborates with business leaders and management on program development and planning for departmental initiatives including those that have a corporate wide impact and compensati المزيد...

SummaryWe are currently hiring for a Medical Assistant Health Coach to join BlueCross BlueShield of South Carolina. In this role as a Medical Assistant Health Coach you will assist with health management activities/programs for BlueCross BlueShield of South Carolina (BCBSSC) and/or المزيد...

SummaryPosition Purpose:The primary objective of this position is to lead investigations/audits to validate accuracy of charges submitted to the corporation for payment for the purpose of cost containment. Analyzes statistical data findings to detect overpayments from claims processin المزيد...

SummaryReviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise administrative policies and established clinical criteria to service requests or provides health management program interventions. Utilizes clinical المزيد...

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics:This is a PartTime position (20 HPW). Our ideal candidate will work onsite at our Florence SC location.What Youll Do:Research and processes claims according to business regulation internal standar المزيد...

SummaryResponsible for identifying training needs developing training materials and facilitating training. Provides training guidance and leadership for new training specialists. Develops performance assessments and testing materials. Manages trainees and communicates effectively with المزيد...

SummaryPerforms nonmedical reviews and processes redetermination letters.DescriptionLocationThis position is hybrid at our Columbia SC location. Full time 40hr work week typical office hours range 6am6pmWhat You Will Do:Performs nonmedical reviews and processes redetermination letters المزيد...

SummaryResponsible for accurate and timely processing of system updates for new groups and changes in CES MMGC BDS and PIRS. This position requires positive customeroriented communication with all parties involved in the sales process to ensure the highest level of customer satisfact المزيد...

SummaryProvides a wide variety of administrative and staff support services. Coordinates more complex and diverse area specific projects. Administers programs projects and processes requiring area specific knowledge. Operates a desktop computer and is proficient in working with assort المزيد...

SummaryProvides clerical and administrative support to the training and development function by entering data into the Learning Management System (LMS) maintaining training library ordering supplies and assisting trainers with class preparation.DescriptionLogistics: PGBA one of BlueC المزيد...

SummaryCare management interventions focus on improving care coordination and reducing the fragmentation of the services the recipients of care often experience especially when multiple health care providers and different care settings are involved. Taken collectively care management المزيد...

SummaryAs an HRIS Analyst you will deliver customer service support for HR inquiries related to the HCM system provide secondtier support for escalated issues and manage system enhancements. You will also collaborate with internal stakeholders to analyze requirements and recommend and المزيد...

SummarySenior level position focused on improving provider data quality by auditing the work of Provider Enrollment Analysts and Senior Provider Enrollment Analysts. Develops reports to keep management informed of the overall quality control of Provider Information Management Systems المزيد...

SummaryProvides prompt accurate thorough and courteous responses to all customer inquiries. Performs research as needed to resolve inquiries.DescriptionLocation:This position is fulltime (40 hours/week) MondayFriday in a typical office environment. Employees are required to have flex المزيد...

SummaryDescriptionLogistics:This is a full time (40 HPW) position and our ideal candidate will work onsite at our Columbia SC location.What Youll Do:Research claims history to identify claims to be adjusted for refunds. Update claims systems to ensure that the refund process will be c المزيد...

SummaryResponsible for ensuring the prompt appropriate and accurate distribution of case files and maintaining statistics on questionnaires ROC06 claims and caseloads.DescriptionLocation:This position is fulltime (40 hours/week) MondayFriday in a typical office environment. Employees المزيد...

SummaryProvides direction and guidance to training coaching and quality staff for multiple operational areas. Collaborates with operational leadership to ensure Develop and Implement Training Programs: Create and oversee training initiatives that align with organizational goals and e المزيد...