BlueCross and BlueShield of South Carolina

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 More...

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 More...

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 More...

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 More...

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 More...

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...

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...

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...

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...

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...

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...

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...

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 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...