BlueCross and BlueShield of South Carolina

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

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 More...

SummaryResponsible for providing a full range of financial compliance and operational audits business advisory and consultation services investigations internal controls accountability and use of resources.DescriptionLocation: This position is full-time (40-hours/week) Monday-Friday w More...

SummaryPosition Purpose: The Assistant Vice President Medicaid Healthcare Management provides leadership direction and oversight (clinical operations) in the establishment of strategic direction for physical and behavioral health Utilization Management (prior authorization inpatient r More...

SummarySupervises daily activies performed by the Model Audit Rule (MAR/SOX) Department in the compliance effort that results in annual reporting to the Department of Insurance in activities such as but not limited to: risk assessments process documentation (Financial Operational and More...

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA is a subsidiary company of BlueCross BlueShield of South Carolina.Location:This position is full-time (40 hours/week) Monday-Friday in a typical office environment. Employees are required t More...

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

SummaryWe are currently hiring for a Medical Reviewer II to join BlueCross BlueShield of South Carolina. In this role as a Medical Reviewer II you will perform medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or More...

SummaryWe have an opening for the position of Senior Subrogation Specialist at BlueCross BlueShield of South Carolina. In this role you will identify and pursue subrogation and workers compensation recoveries. You will negotiate settlements of amounts owed to the company. The position More...

SummaryResponsible for supporting the development and maintenance of a digital media strategy. Responsible for leading digital marketing efforts coordination of marketing campaigns content management monitoring traffic and responding to feedback. Various digital properties include web More...

SummaryWhy 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 insurance c More...

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

SummaryWe are currently hiring for a Pharmacy Operations Analyst to join BlueCross BlueShield of South Carolina. In this role as a Pharmacy Operations Analyst you will provide key operations support and guidance on the Pharmacy Benefit Management (PBM) Support Team. Serves as an opera More...

SummaryResponsible for making underwriting and pricing recommendations to complete Commercial ASO Pharmacy quotes and Requests for Proposals (RFPs). *Prior Pharmacy Benefit Management (PBM) pricing experience preferred.DescriptionLocation:This is a full-time remote position working ( More...

SummaryWe are currently hiring for a Claims Customer Service Advocate II to join BlueCross BlueShield of South Carolina. In this role as a Claims Customer Service Advocate II you will be responsible for responding to customer inquiries. Inquiries may be non-routine and require deviat More...

SummaryResponsible for daily workflow activities to include the following membership/enrollment activities: processing of applications for new enrollments terminations/cancellations changes renewals database updates and/or monthly billings.DescriptionLogistics: This is a full-time (4 More...

SummaryResponsible for responding to routine inquiries. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return deny or pay claims following organizatio More...

SummaryWe are currently hiring for a Medical Reviewer I to join BlueCross BlueShield of South Carolina. In this role as a Medical Reviewer I you will perform medical reviews using established criteria sets and/or performs utilization management of professional inpatient or outpatient More...

SummaryDepending on department needs this job includes the following: cashier prep cook food server dishwasher/pot washer catering delivery restocking as needed and any other need as asked by management.DescriptionLocation: This position is full-time (40-hours/week) Monday-Friday in a More...

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