BlueCross BlueShield of South Carolina

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companiesLocation: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role is

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companiesLocation: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role is

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 first-class correspondence statements checks etc.*Mail procedures require the adherence

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 first-class correspondence statements checks etc.*Mail procedures require the adherence

SummaryActs as a Team Lead by providing guidance/direction/training to Provider Enrollment Analysts and/or other Provider Enrollment area staff. Responsible for the processing of difficult enrollment applications and/or complex inquiries.DescriptionLogistics: Palmetto GBA one of Blue

SummaryActs as a Team Lead by providing guidance/direction/training to Provider Enrollment Analysts and/or other Provider Enrollment area staff. Responsible for the processing of difficult enrollment applications and/or complex inquiries.DescriptionLogistics: Palmetto GBA one of Blue

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

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

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

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

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

SummaryProvides prompt accurate thorough and courteous responses to all customer inquiries. Inquiries 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. Inquiries 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

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

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

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

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

SummaryProvides education and training support for network providers/staff/suppliers/physicians/beneficiaries/referral agents as necessary. Develops and produces training and educational materials.DescriptionLogistics: Palmetto GBA one of BlueCross BlueShields South Carolina subsidiar

SummaryProvides education and training support for network providers/staff/suppliers/physicians/beneficiaries/referral agents as necessary. Develops and produces training and educational materials.DescriptionLogistics: Palmetto GBA one of BlueCross BlueShields South Carolina subsidiar

SummaryScreen code and key claims in claims system. Ensure claims are processed in a timely manner.DescriptionLocation: This position is full-time (40 hours/week) Monday-Friday from 8:00am-5:00pm. This role is located on-site at 17 Technology Circle Columbia SC 29203.What Youll Do: Sc

SummaryScreen code and key claims in claims system. Ensure claims are processed in a timely manner.DescriptionLocation: This position is full-time (40 hours/week) Monday-Friday from 8:00am-5:00pm. This role is located on-site at 17 Technology Circle Columbia SC 29203.What Youll Do: Sc

SummaryInterprets all directives and policies to establish processing guidelines for area of expertise. Works with the systems department to create edits/audits and other related changes for the claims system. Maintains and monitors existing edits/audits and requests all maintenance f

SummaryInterprets all directives and policies to establish processing guidelines for area of expertise. Works with the systems department to create edits/audits and other related changes for the claims system. Maintains and monitors existing edits/audits and requests all maintenance f

SummaryCreates and analyzes reports to support operations. Ensures correctness of analysis and reports findings in a concise manner to senior management. Directly responsible for accuracy of data as financial and operational decisions are made based on the data provided.DescriptionW

SummaryCreates and analyzes reports to support operations. Ensures correctness of analysis and reports findings in a concise manner to senior management. Directly responsible for accuracy of data as financial and operational decisions are made based on the data provided.DescriptionW

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

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

SummaryFunctions as work leader for a claims customer service unit responsible for resolving customer inquiries and performing initial claims adjudication or non-medical appeals review. Assists with escalated and complex issues.DescriptionLogistics: Planned Administrators Inc. (PAI)

SummaryFunctions as work leader for a claims customer service unit responsible for resolving customer inquiries and performing initial claims adjudication or non-medical appeals review. Assists with escalated and complex issues.DescriptionLogistics: Planned Administrators Inc. (PAI)

SummaryResponsible in the provider enrollment process to review research analyze and process provider enrollment applications. Ensures provider file integrity and that suppliers are in compliance with established standards and guidelines.DescriptionLogistics: CGS () one of BlueCross B

SummaryResponsible in the provider enrollment process to review research analyze and process provider enrollment applications. Ensures provider file integrity and that suppliers are in compliance with established standards and guidelines.DescriptionLogistics: CGS () one of BlueCross B

SummaryProvides professional administrative support for a department. Functions include: typing verification of accuracy copying faxing updating records filing ordering supplies preparing travel arrangements coordinating special projects creating complex spreadsheets and handling rout

SummaryProvides professional administrative support for a department. Functions include: typing verification of accuracy copying faxing updating records filing ordering supplies preparing travel arrangements coordinating special projects creating complex spreadsheets and handling rout

SummarySupervises provider enrollment and quality assurance staff. Ensures providers are loaded accurately/timely into system appropriately assigned to networks and updated correctly when necessary. Manages activities related to the provider file including file maintenance quality a

SummarySupervises provider enrollment and quality assurance staff. Ensures providers are loaded accurately/timely into system appropriately assigned to networks and updated correctly when necessary. Manages activities related to the provider file including file maintenance quality a

SummaryProvides professional administrative support for a department. Functions include: typing verification of accuracy copying faxing updating records filing ordering supplies preparing travel arrangements coordinating special projects creating complex spreadsheets and handling rout

SummaryProvides professional administrative support for a department. Functions include: typing verification of accuracy copying faxing updating records filing ordering supplies preparing travel arrangements coordinating special projects creating complex spreadsheets and handling rout

SummaryThe Physician Advisor optimizes efficient management of resources ensuring patients are in the appropriate level of care supporting documentation coding improvements and compliance and monitoring the appropriate use of diagnostic and therapeutic modalities. Provides assessment

SummaryThe Physician Advisor optimizes efficient management of resources ensuring patients are in the appropriate level of care supporting documentation coding improvements and compliance and monitoring the appropriate use of diagnostic and therapeutic modalities. Provides assessment