BlueCross and BlueShield of South Carolina

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. Provides support and re More...

SummaryWe are currently hiring for a Retail Center Sales Representative to join BlueCross BlueShield of South Carolina. In this role as Retail Center Sales Representative you will be responsible for providing consultative sales and service to customers seeking health and ancillary ins More...

SummaryProvides direction and guidance to customer service claims processing and/or appeals staff for multiple operational areas.DescriptionLogistics: PGBA One of BlueCross BlueShields South Carolina subsidiary companies.Location:This is a fulltime position working 40hours/week) Mon More...

SummaryThis position is part of our RCD (Review Choice Demonstration) Medicare Medical Review and Health Quality Team for Palmetto GBA. Position will be work from home after 46 months of onsite training in our Florence SC office. To work from home you must have highspeed nonsatellite More...

SummaryWe are currently hiring for a Managed Care Coordinator II/CMDM to join BlueCross BlueShield of South Carolina. In this role for care management interventions you will focus on improving care coordination and reducing the fragmentation of the services the recipients of care ofte More...

SummaryPromotes blended learning solutions and the use of innovative technology and tools to meet business goals of developing a highperforming workforce. Produces webenabled elearning traditional educational materials or a blended solution using leadingedge technologyDescriptionLocat 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...

SummaryReviews and adjudicates complex or specialty claims. Determines whether to return deny or pay claims following organizational policies and procedures. Assists in training or mentoring new staff members.DescriptionLogistics: PGBA is a subsidiary company of BlueCross BlueShiel 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...

SummaryAssists Retail Manager in coordinating store activities in order to achieve successful implementation of sales/marketing initiatives and materials to promote designated retail product lines to meet predetermined sales goals. Provides leadership and support to store staff in or More...

SummaryProvide prompt accurate thorough and courteous responses to all telephone inquiries. Perform research as needed to resolve inquiries.DescriptionLocation: This position is fulltime 40hours/week) MondayFriday in a typical office environment. This role is located onsite at 200 Doz More...

SummaryDescriptionJob DescriptionWhy 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 a More...

SummaryResponsible for the engineering of network infrastructure. Designs infrastructures including hardware software and various configurations. Ensures that the design and integration of proposed solutions leads to the development and growth of the business through effective use of More...

SummaryProvides blended learning solutions and the use of innovative technology and tools to meet business goals. Responsible for training developing and coaching activities in various areas. This includes the analysis design delivery evaluation and maintenance required to manage the 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...

SummaryReviews and adjudicates complex or specialty claims. Determines whether to return deny or pay claims following organizational policies and procedures. Assists in training or mentoring new staff members.DescriptionLogistics: PGBA is a subsidiary company of BlueCross BlueShiel More...

SummaryProvides prompt accurate thorough and courteous responses to all customer inquiries. Inquiries may be nonroutine and require deviation from standard screens scripts and procedures. Performs research as needed to resolve inquiries.DescriptionLocation: This position is fulltime 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...

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...

SummaryThis position completes research efficiently and accurately to ensure the departmental goals to prevent aging of claims and erroneous disbursements or claims from processing incorrectly. This position also assists in any special projects that may arise.DescriptionWhat Youll Do: More...