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 fulltime position 40 HOW). This position will require our ideal candidate to work onsite.What You Will Do:Screen code and key claims to ensure proper and More...

SummaryOutside Sales Representative responsible for selling Health Insurance products in South Carolina. Responsible for new sales renewal of existing members and providing service as needed. Product Portfolio for group and individual consumers include ACA Plans and Medicare for eligi More...

SummaryProvide prompt accurate thorough and courteous responses to all customer inquiries. Inquires may be nonroutine and require deviation from standard screens scripts and procedures. Perform research as needed to resolve inquiries.DescriptionLocationThis position is full time 40 ho More...

SummaryEstablishes and maintains provider networks for assigned lines of business. Serves as main contact for all recruiting or recontracting efforts and all contract questions or issues that arise with providers. Recommends and implements costeffective strategies while delivering hig 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...

SummaryResponsible for daily workflow activities to include the following membership/enrollment activities: processing of applications for new enrollments terminations/cancellations changes renewals and database updates.DescriptionWhat Youll Do:Receives and logs subscriber and member More...

SummaryPerforms advanced varied clerical duties in accordance with standard procedures. This includes clerical duties such as photocopying compiling records filing tabulating posting information and distributing mail. Applies knowledge of department policies and procedures and utilize More...

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics:This is a fulltime 40 HOPW) position.Our ideal candidate will be required to work in our Florence SC location.What You Will Do:Research and process claims according to business regulation internal More...

SummaryPerforms quality control audits to evaluate accuracy and effectiveness of departmental operations functions including but not limited to claims membership customer service/call center workflow processing support systems procedures documentation etc. Identifies problems analyze More...

SummaryWe are currently hiring for a Stop Loss Accounting Analyst to join BlueCross BlueShield of South Carolina. In this role as Stop Loss Accounting Analyst you will be responsible for submitting stop loss claim packets and responding to any requests for additional information. Addi More...

SummaryFunctions as work leader for a claims customer service unit responsible for resolving customer inquiries and performing initial claims adjudication or nonmedical appeals review. Assists with escalated and complex issues.DescriptionLocation:This position is fulltime 40hours/wee More...

SummaryReceive shipments from supply department and outside vendors. Pull inventory (inserts envelopes) for each job/operator. Deliver/Replenish operator supplies. Keep inserts and envelopes organized on production floor and in warehouse. Keep production floor and warehouse free from 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 RN Quality Improvement Policy Coordinator to join BlueCross BlueShield of South Carolina. This individual will perform vendor audits and oversight. They will provide reporting to the vendors Governance Committee the executive team and other stakeh More...

SummaryProvides prompt accurate thorough and courteous responses to all complex customer inquiries. Inquiries are typically nonroutine and require deviation from standard screens scripts and procedures. Performs research as needed to resolve inquiries.DescriptionLocation: This positio More...

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

SummaryResearches and resolves escalated complex and high profile claims issues. Serves as POC (point of contact) with various professional and facility/hospital providers in the research and resolution of all claims issues. May assist with escalated issues to include but not limited More...

SummaryUnder direct supervision performs quality control audits reviews or monitoring of departmental operations functions including but not limited to claims membership customer service/call center workflow processing support systems procedures documentation etc. Identifies problems More...

SummaryResponsible for responding to customer inquiries. Inquiries may be nonroutine and require deviation from standard screens scripts and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or nonmedical appeals. Determines whether t More...

SummaryResponsible for operating high speed file based integrity production mail inserters and other print/mailing equipment to meet the companys required contractual obligations related to mailing firstclass correspondence statements checks etc. **Mail procedures require the adherenc More...