CGS Administrators

SummarySupervises a team of employees responsible for customer service.DescriptionLogistics CGS one of BlueCross BlueShields South Carolina subsidiary companies.Location: This position is full-time (40-hours/week) Monday-Friday in a typical office environment. This role is located on More...

SummaryWorking at CGS AdministratorsCGS 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 33 states supporting the needs of more than 20 mil More...

SummaryPrepares and revises automated cost report data files to incorporate audit adjustments and to ensure that cost reports meet all requirements for acceptance. Processes original filing and settlement cost reports.DescriptionWhy should you join the BlueCross BlueShield of South Ca More...

SummaryResponsible for entry level accounting activities relating to the maintenance of a complete and accurate general ledger and/or the resultant managerial reports and/or financial statements.DescriptionWhy should you join the BlueCross BlueShield of South Carolina family of compan More...

SummaryWorking at CGS AdministratorsCGS 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 33 states supporting the needs of more than 20 mil More...

SummaryPerforms non-medical reviews and processes redetermination letters.DescriptionLocationThis position is hybrid schedule (3 days onsite 2 days remote) in Nashville TN full time (40 hours/week) Monday-Friday.SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its More...

SummaryPosition Purpose: Responsible for the effective and efficient control of all claims processing and/ as well as oversight of the CGS Document Management Center. Develops and executes strategic and operational business plans for the departmentDescriptionLogistics: CGS () one of More...

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.DescriptionLogistics: CGS () one of BlueCross More...

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics:This is a fulltime (40 HPW) position. Our ideal candidate will work onsite at our Tennessee location.What Youll Do:Research and process claims according to business regulation internal standards a More...

SummaryDescriptionLogistics:This is a fulltime (40 HPW) position. Our ideal candidate will work onsite at our Florence location.What Youll Do:Research and process claims according to business regulation internal standards and processing guidelines. Verifies the coding of procedure and More...

SummaryWorking at CGS AdministratorsCGS 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 33 states supporting the needs of more than 20 mil More...

SummaryPosition Purpose:Responsible for assisting in the execution of financial compliance and operational audits including evaluation of internal controls. Audit the activity of various departments and providers for compliance with plans policies and procedures prescribed by manageme 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...

SummarySupervises area responsible for EDI support and oversees projects in area.DescriptionLocation:This role is located at our Nashville TN location with the possibility for remote work as well. MF 8am5pmWhat You Will Do:Provides supervision and oversight of daytoday operations and More...

SummaryWe are currently hiring for a Claims Customer Service Supervisor to join CGS/BlueCross BlueShield of South Carolina. In this role as a Claims Customer Service Supervisor you will be responsible for supervising a team of employees responsible for claims appeals and/or customer s More...

SummaryWe are currently hiring for an Appeals Specialist to join BlueCross BlueShield of South Carolina. In this role as Appeals Specialist you will be required to perform nonmedical reviews and process redetermination letters.Why should you join the BlueCross BlueShield of South Caro 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...

SummaryReviews and adjudicates complex or specialty claims. Determines whether to return deny or pay claims following organizational policies and procedures. Assists in training or mentoring new staff members.DescriptionWhat You Will Do:Examine and processes complex or specialty cla More...

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 (cgsadmin) one of Bl More...

SummaryResponsible for assisting in the of financial compliance and operational audits including evaluation of internal controls. Audit the activity of various departments and providers for compliance with plans policies and procedures prescribed by management. Review assigned portio More...