Appeals Specialist

Summary

We are currently hiring for an Appeals Specialist to join BlueCross BlueShield of South this role as Appeals Specialist you will perform non-medical 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) Monday-Friday 8 : 00-5 : 00 and will be located on-site at our Columbia GPC location.

What You Will Do :

Perform non-medical 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.

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 :

IC

Key Skills

Sales Experience,Crane,Customer Service,Communication skills,Heavy Equipment Operation,Microsoft Word,Case Management,OSHA,Team Management,Catheterization,Microsoft Outlook Calendar,EHS

Employment Type : Full-Time

Experience : years

Vacancy : 1