CGS Administrators

SummaryPerforms medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims

SummaryPerforms medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims

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.DescriptionJob DescriptionPosition Purpose:From the moment of login y

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.DescriptionJob DescriptionPosition Purpose:From the moment of login y

SummaryCGS culture is steeped in how we impact lives within our community and organization. Our culture is invested in six core values: Integrity; Making a Difference; Passion for Excellence; Always Improving; Customer Focused; and Taking Risks. CGS IT is a collaborative fast-paced en

SummaryCGS culture is steeped in how we impact lives within our community and organization. Our culture is invested in six core values: Integrity; Making a Difference; Passion for Excellence; Always Improving; Customer Focused; and Taking Risks. CGS IT is a collaborative fast-paced en

SummaryResponsible for training activities in an assigned area(s). Note: some areas may require varying degrees of emphasis or concentration within this general description.DescriptionLogistics: () one of BlueCross BlueShields South Carolina subsidiary companies. Location: This posit

SummaryResponsible for training activities in an assigned area(s). Note: some areas may require varying degrees of emphasis or concentration within this general description.DescriptionLogistics: () one of BlueCross BlueShields South Carolina subsidiary companies. Location: This posit

SummaryWorking at CGS AdministratorsCGS 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 Medi

SummaryWorking at CGS AdministratorsCGS 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 Medi

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

SummaryPerforms non-medical reviews and processes redetermination letters.DescriptionCGS Administrators provides a variety of services under contracts with the Centers for Medicare and Medicaid Services (CMS) for beneficiaries health care providers and medical equipment suppliers in 3

SummaryPerforms non-medical reviews and processes redetermination letters.DescriptionCGS Administrators provides a variety of services under contracts with the Centers for Medicare and Medicaid Services (CMS) for beneficiaries health care providers and medical equipment suppliers in 3

SummaryWe are currently hiring for a Claims Customer Service Advocate II to join CGS/BlueCross BlueShield of South Carolina. You will be responsible for responding to customer inquiries. Inquiries may be non-routine and require deviation from standard screens scripts and procedures.

SummaryWe are currently hiring for a Claims Customer Service Advocate II to join CGS/BlueCross BlueShield of South Carolina. You will be responsible for responding to customer inquiries. Inquiries may be non-routine and require deviation from standard screens scripts and procedures.

SummaryResponsible for providing a full range of financial compliance and operational audits business advisory and consultation services investigations internal controls accountability and use of resources.DescriptionThe Auditor II is a full-time remote position working 8:00-5:00 p.m.

SummaryResponsible for providing a full range of financial compliance and operational audits business advisory and consultation services investigations internal controls accountability and use of resources.DescriptionThe Auditor II is a full-time remote position working 8:00-5:00 p.m.

SummaryEnsures the accuracy and quality of data that had been systematically or manually entered into an indexing system.DescriptionLogistics: CGS () one of BlueCross BlueShields South Carolina subsidiary companies.Location: This position is full-time (40-hours/week) Monday-Friday fr

SummaryEnsures the accuracy and quality of data that had been systematically or manually entered into an indexing system.DescriptionLogistics: CGS () one of BlueCross BlueShields South Carolina subsidiary companies.Location: This position is full-time (40-hours/week) Monday-Friday fr

SummaryActs as Team Lead for specialty programs medical review utilization management and case management areas by providing assistance and support to unit supervisor/manager by giving direction/guidance/training to staff. Ensures appropriate levels of healthcare services are provide

SummaryActs as Team Lead for specialty programs medical review utilization management and case management areas by providing assistance and support to unit supervisor/manager by giving direction/guidance/training to staff. Ensures appropriate levels of healthcare services are provide

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: CGS () one of BlueCross

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: CGS () one of BlueCross

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

SummaryPerforms medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims

SummaryPerforms medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims