BlueCross and BlueShield of South Carolina

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 More...

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 More...

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 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. Reviews and adjudicates complex 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...

SummaryResponsible for establishing and maintaining certification and/or preparation review and/or maintenance of healthcare provider files in support of provider directories accurate/timely claims adjudication and provider billing.DescriptionLogistics: PGBA one of BlueCross BlueShie More...

SummaryResponsible for establishing and maintaining certification and/or preparation review and/or maintenance of healthcare provider files in support of provider directories accurate/timely claims adjudication and provider billing.DescriptionLogistics: PGBA one of BlueCross BlueShie More...

SummaryResponsible for establishing and maintaining certification and/or preparation review and/or maintenance of healthcare provider files in support of provider directories accurate/timely claims adjudication and provider billing.DescriptionLogistics: PGBA is a subsidiary company o More...

SummaryJob Description SummaryPerforms medical reviews using established criteria sets and/or performs utilization management of professional inpatient or outpatient facility benefits or services and appeals. Documents decisions using indicated protocol sets or clinical guidelines. More...

SummaryAnalyze data for creation of statistical reports used for program or process evaluation. Responsible for maintaining databases and extracting data for analysis. Runs and reviews reports analyzing results in support of operational functions.DescriptionLogistics: PGBA one of Bl 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 posit More...

SummaryPerforms routine but 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 util More...

SummaryResponsible for the accurate and timely processing of claims.DescriptionLocation: This position is fulltime (40hours/week) MondayFriday in a typical office environment. This role is located onsite at 300 North Dozier Blvd. Florence SC 29501.What Youll Do:Research and process cl More...

SummaryResponsible for the sales service and administrative activities and relationship management to prospective and existing accounts. Customarily and regularly engaged in outside sales.DescriptionLocation:This is a fulltime position working remotely (40hours/week) MondayFriday. You 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...

SummaryFunctions as the subject matter expert and work leader for a team of operations quality auditors by assigning monitoring and auditing their work. Ensures audit performance and reporting deadlines are met. Promotes customer satisfaction both internally and externally through con 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...

SummaryResponsible for configuring installing and maintaining desktop software and hardware. Provides technical support and guidance to users.DescriptionPosition Purpose:This role entails assembling all desktop and peripheral orders. The analyst will work directly with customers to d 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...

SummaryDevelops test plans and test matrices conducts testing and reports test results for system changes. Coordinates implementation and debugging of new software ensuring that the new or modified applications work in the production environment and meet the expectations of customers. More...