BlueCross BlueShield of South Carolina

SummaryResponsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions.DescriptionLogistics: PGBA is a subsidiary company of BlueCross Blue

SummaryResponsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions.DescriptionLogistics: PGBA is a subsidiary company of BlueCross Blue

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 ass

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 ass

SummaryDescriptionWhy 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 are the largest

SummaryDescriptionWhy 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 are the largest

SummaryPosition Purpose:Responsible for providing a full range of financial compliance and operationalaudits business advisory and consultation services investigations internalcontrols accountability and use of resources.DescriptionLogistics: Palmetto GBA one of BlueCross BlueShields

SummaryPosition Purpose:Responsible for providing a full range of financial compliance and operationalaudits business advisory and consultation services investigations internalcontrols accountability and use of resources.DescriptionLogistics: Palmetto GBA one of BlueCross BlueShields

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 BlueC

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 BlueC

SummaryResponsible for the coordination and completion of the audit reviews reviewing audit work papers and reports completed by department staff distributing reports to management coordinating auditors assignments mentoring and coaching department staff and assisting the department m

SummaryResponsible for the coordination and completion of the audit reviews reviewing audit work papers and reports completed by department staff distributing reports to management coordinating auditors assignments mentoring and coaching department staff and assisting the department m

SummaryDescriptionWhy 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 are the largest

SummaryDescriptionWhy 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 are the largest

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: Palmetto GBA one of Blue

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: Palmetto GBA one of Blue

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

SummaryJoin our appeals team to performs non-medical reviews and processes redetermination letters.DescriptionLocationThis position is onsite in Nashville TN full time (40 hours/week) Monday-Friday starting between 6am and 9am to best fit your needs.SCA Benefit Requirements: BlueCross

SummaryJoin our appeals team to performs non-medical reviews and processes redetermination letters.DescriptionLocationThis position is onsite in Nashville TN full time (40 hours/week) Monday-Friday starting between 6am and 9am to best fit your needs.SCA Benefit Requirements: BlueCross

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

SummaryResponsible for responding to customer inquiries. Inquiries may be non-routine and require deviation from standard screens scripts and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals. Determines whether

SummaryResponsible for responding to customer inquiries. Inquiries may be non-routine and require deviation from standard screens scripts and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals. Determines whether

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: Palmetto GBA one of Blu

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: Palmetto GBA one of Blu

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

SummaryResponsible for providing a full range of risk compliance and operational underwriting audits. ( business advisory and consultation services investigations internal controls accountability and use of resources.)DescriptionLocation: This position is full-time(40-hours/week) Remo

SummaryResponsible for providing a full range of risk compliance and operational underwriting audits. ( business advisory and consultation services investigations internal controls accountability and use of resources.)DescriptionLocation: This position is full-time(40-hours/week) Remo

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

SummaryResponsible for planning development direction and management of all activities related to product development for assigned divisions business. Determines the demand for new or enhanced products and services through market research and analysis. Responsible for the development

SummaryResponsible for planning development direction and management of all activities related to product development for assigned divisions business. Determines the demand for new or enhanced products and services through market research and analysis. Responsible for the development

SummaryAs a People Systems HRIS Analyst you will deliver customer service support for HR inquiries related to the HCM system provide second-tier support for escalated issues and manage HCM system enhancements. You will also collaborate with internal stakeholders to analyze requirement

SummaryAs a People Systems HRIS Analyst you will deliver customer service support for HR inquiries related to the HCM system provide second-tier support for escalated issues and manage HCM system enhancements. You will also collaborate with internal stakeholders to analyze requirement

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

SummaryLeads multi divisional area needs regarding the planning and prioritization of Clinical systems and support related activities including projects process improvements develops and provides information to drive the clinical decision-making process for divisional projects and job

SummaryLeads multi divisional area needs regarding the planning and prioritization of Clinical systems and support related activities including projects process improvements develops and provides information to drive the clinical decision-making process for divisional projects and job