Appeals Specialist

Non-Medical Reviewer

Performs non-medical reviews and processes redetermination letters.

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.

This position is hybrid schedule (3 days onsite, 2 days remote) in Nashville, TN, full time (40 hours / week) Monday-Friday.

Under the McNamara-O'Hara 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.

To qualify for this position, you will need :

• High school diploma or equivalent
• 2 years in a job-related field
• 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 :

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.

If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 800-288-2227, 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.