Appeals Specialist
Appeals Specialist
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Job Description
Summary
Performs non-medical reviews and processes redetermination letters.
Description
Location
This 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 subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). Under the McNamara-OHara Service Contract Act (SCA) employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date.
What You Will Do:
Performs non-medical reviews and processes redetermination letters ensuring timeliness and accuracy
Prepares unit reports analyzes and interprets workload and processes issues utilizing various software tools
Updates 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:
Required Education: High school diploma or equivalent
Required work experience: 2 years in a job-related field
Required Skills and abilities: Demonstrated proficiency in word processing and spreadsheet software excellent organizational customer-service and written and oral communications skills good judgment proficiency in spelling punctuation and grammar microsoft Office 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.
On-site 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.
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 individuals with disabilitiesand protected 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 disabilities pregnant individuals individuals with pregnancy-related conditions and individuals needing accommodations for sincerely held religious beliefs provided that those accommodations do not impose an undue hardship on the Company.
If you need special assistance or an accommodation while seeking employment please email or call ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Heres moreinformation.
Some states have required notifications. Heres more information.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
