BlueCross BlueShield of South Carolina

SummaryServes as the primary liaison to BlueCross Association driving strategic alignment IT oversight and cross-functional collaboration. Leads policy development performance measurement and long-range planning to ensure compliance operational excellence and achievement of corporate

SummaryServes as the primary liaison to BlueCross Association driving strategic alignment IT oversight and cross-functional collaboration. Leads policy development performance measurement and long-range planning to ensure compliance operational excellence and achievement of corporate

SummaryResearches the substance of complex appeal or retrospective review requests including pre-pay and post-payment review appeal requests. Provides thorough clinical review or benefit analysis to determine if the requested services meet medical necessity guidelines. Documents deci

SummaryResearches the substance of complex appeal or retrospective review requests including pre-pay and post-payment review appeal requests. Provides thorough clinical review or benefit analysis to determine if the requested services meet medical necessity guidelines. Documents deci

SummaryProvides prompt accurate thorough and courteous responses to all customer inquiries. Inquires may be non-routine and require deviation from standard screens scripts and procedures. Performs research as needed to resolve inquiries.DescriptionLocation: This position is full-tim

SummaryProvides prompt accurate thorough and courteous responses to all customer inquiries. Inquires may be non-routine and require deviation from standard screens scripts and procedures. Performs research as needed to resolve inquiries.DescriptionLocation: This position is full-tim

SummaryAnalyzes 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.DescriptionWhy should you join the Bl

SummaryAnalyzes 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.DescriptionWhy should you join the Bl

SummaryWe have a job opening for the position of Business Management Summer Student Intern at Palmetto GBA a subsidiary of BlueCross BlueShield of South Carolina. The Intern position is utilized for training an active high school or college student towards an entry level role. The re

SummaryWe have a job opening for the position of Business Management Summer Student Intern at Palmetto GBA a subsidiary of BlueCross BlueShield of South Carolina. The Intern position is utilized for training an active high school or college student towards an entry level role. The re

SummaryBuilds and maintains effective long-term relationships with internal and external partners. Ensuring high levels of satisfaction and increase revenues through profitable new case pricing and drive renewal add issue sales. Supports reporting evaluation and additional development

SummaryBuilds and maintains effective long-term relationships with internal and external partners. Ensuring high levels of satisfaction and increase revenues through profitable new case pricing and drive renewal add issue sales. Supports reporting evaluation and additional development

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

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

SummaryResponsible for setting up cases for pharmacy authorization requests and performing pharmacy reviews as per established criteria. Maintains the timely complete and accurate processing of authorization requests by interfacing with internal and external customers and the Pharmacy

SummaryResponsible for setting up cases for pharmacy authorization requests and performing pharmacy reviews as per established criteria. Maintains the timely complete and accurate processing of authorization requests by interfacing with internal and external customers and the Pharmacy

SummaryWe have a job opening for the position of Summer Student Intern Actuarial position at BlueCross BlueShield of South Carolina. Intern position is utilized for training an active college student towards a professional-level role. The responsibilities vary and are based upon the

SummaryWe have a job opening for the position of Summer Student Intern Actuarial position at BlueCross BlueShield of South Carolina. Intern position is utilized for training an active college student towards a professional-level role. The responsibilities vary and are based upon the

SummaryCGS Administrators LLC (CGS) is part of BCBSSCs Celerian Group of companies and provides a variety of services for Medicare beneficiaries healthcare providers and medical equipment suppliers in 38 states supporting the needs of over 8.7 million Medicare beneficiaries and 103000

SummaryCGS Administrators LLC (CGS) is part of BCBSSCs Celerian Group of companies and provides a variety of services for Medicare beneficiaries healthcare providers and medical equipment suppliers in 38 states supporting the needs of over 8.7 million Medicare beneficiaries and 103000

SummaryResponsible for assisting in the execution of financial compliance and operational audits including evaluation of internal controls. Audits the activity of various departments and providers for compliance with plans policies and procedures prescribed by management. Reviews assi

SummaryResponsible for assisting in the execution of financial compliance and operational audits including evaluation of internal controls. Audits the activity of various departments and providers for compliance with plans policies and procedures prescribed by management. Reviews assi

SummaryWe have a job opening for the Electronic Data Interchange (EDI) Summer Student Intern at Palmetto GBA a subsidiary of BlueCross BlueShield of South Carolina. The Intern position is utilized for training an active high school or college student towards an entry level role. The

SummaryWe have a job opening for the Electronic Data Interchange (EDI) Summer Student Intern at Palmetto GBA a subsidiary of BlueCross BlueShield of South Carolina. The Intern position is utilized for training an active high school or college student towards an entry level role. The

SummaryProvides education to medical providers as warranted.DescriptionLogistics: CGS () one of BlueCross BlueShields South Carolina subsidiary companies.Government Clearance: This position requires the ability to obtain a security clearance which requires applicants to be a U.S. Citi

SummaryProvides education to medical providers as warranted.DescriptionLogistics: CGS () one of BlueCross BlueShields South Carolina subsidiary companies.Government Clearance: This position requires the ability to obtain a security clearance which requires applicants to be a U.S. Citi

SummaryDescriptionLogistics: Palmetto GBA one of BlueCross BlueShields South Carolina subsidiary companies.Location:This position is full time (40 hours/week) Monday-Friday from 8:00am 5:30pm and will be on-site in Florence SC.Government Clearance: This position requires the ability

SummaryDescriptionLogistics: Palmetto GBA one of BlueCross BlueShields South Carolina subsidiary companies.Location:This position is full time (40 hours/week) Monday-Friday from 8:00am 5:30pm and will be on-site in Florence SC.Government Clearance: This position requires the ability

SummaryUnder general supervision performs a variety of routine to moderately complex clerical/accounting functions such as inventory balancing reconciliations generating refund request letters processing disbursements and deposits keying journal entries and logging items in accordance

SummaryUnder general supervision performs a variety of routine to moderately complex clerical/accounting functions such as inventory balancing reconciliations generating refund request letters processing disbursements and deposits keying journal entries and logging items in accordance

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

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

SummaryResponsible for assisting in the execution of financial compliance and operational audits including evaluation of internal controls. Audits the activity of various departments and providers for compliance with plans policies and procedures prescribed by management. Reviews assi

SummaryResponsible for assisting in the execution of financial compliance and operational audits including evaluation of internal controls. Audits the activity of various departments and providers for compliance with plans policies and procedures prescribed by management. Reviews assi

SummaryProvides a wide variety of administrative and staff support services to an organizational unit. Assists in preparation and control of records statistics and reports. Administers the most complex projects and processes specific to operating unit served. May serve as an administr

SummaryProvides a wide variety of administrative and staff support services to an organizational unit. Assists in preparation and control of records statistics and reports. Administers the most complex projects and processes specific to operating unit served. May serve as an administr

SummaryProvides prompt accurate thorough and courteous responses to all customer inquiries. Performs research as needed to resolve inquiries.DescriptionLogistics: Palmetto GBA one of BlueCross BlueShields South Carolina subsidiary companies.Location:This position is Part-time (30 ho

SummaryProvides prompt accurate thorough and courteous responses to all customer inquiries. Performs research as needed to resolve inquiries.DescriptionLogistics: Palmetto GBA one of BlueCross BlueShields South Carolina subsidiary companies.Location:This position is Part-time (30 ho

SummaryWe are currently hiring for a Medication Therapy Management (MTM) Pharmacist to join BlueCross BlueShield of South this role as a Medication Therapy Management (MTM) Pharmacist you will be responsible for performing comprehensive medication reviews and outreach to inform and e

SummaryWe are currently hiring for a Medication Therapy Management (MTM) Pharmacist to join BlueCross BlueShield of South this role as a Medication Therapy Management (MTM) Pharmacist you will be responsible for performing comprehensive medication reviews and outreach to inform and e