Appeals Specialist
Appeals Specialist
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Job Description
Summary
We are currently hiring for an Appeals Specialist to join BlueCross BlueShield of South Carolina. In this role as Appeals Specialist you will perform nonmedical reviews make requested corrections on submitted claims and complete appeal decision letters.Why should you join the BlueCross BlueShield of South Carolina family of companies Other companies come and go but for more than seven decades we have been part of the national landscape with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina and much more. We are one of the nations leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are committed to the same philosophy consider joining our team!
Here is your opportunity to join a dynamic team at a diverse company with secure community roots and an innovative future.
Description
Location
This position is full time 40 hours/week) MondayFriday 8:005:00 and will be located onsite at our Columbia GPC location.
What You Will Do:
Perform nonmedical reviews and process redetermination letters ensuring timeliness and accuracy.
Prepare unit reports analyze and interpret workload and process issues utilizing various software tools.
Update letters and documents within the department when necessary.
May gather and prepare documentation for legal inquiries and administrative requests.
To Qualify for This Position You Will Need:
High School Diploma or equivalent
2 years job related field experience
Demonstrate proficiency in word processing and spreadsheet software
Excellent organizational customer service and written and verbal communication skills
Good judgment skills
Proficiency in spelling punctuation and grammar
Microsoft Office skills
What We Prefer You Have:
Medicare Part B work experience.
Excellent written communication skills.
Good oral communication skills.
What We Can Do for You:
401(k) retirement savings plan with company match.
Subsidized health plans and free vision coverage.
Life insurance.
Paid annual leave the longer you work here the more you earn.
Nine paid holidays.
Onsite cafeterias and fitness centers in major locations.
Wellness programs and healthy lifestyle premium discount.
Tuition assistance.
Service recognition.
Incentive Plan.
Merit Plan.
Continuing education funds for additional certifications and certification renewal.
What to Expect Next:
After submitting your application our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and salary requirements.
Management will be conducting interviews with those candidates who qualify with prioritization given to those candidates who demonstrate the preferred qualifications.
We participate in EVerify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.
Some states have required notifications. Heresmore information.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age race color national origin sex religion veteran status disability weight sexual orientation gender identity genetic information or any other legally protected status. Additionally as a federal contractor the company maintains Affirmative Action programs to promote employment opportunities for minorities females disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal state and local laws and regulations.
We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities.
If you need special assistance or an accommodation while seeking employment please email or callext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a casebycase basis.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
