Appeals Specialists

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<div class="isg-job-description“>Internal Reference Number: R1051150
Summary Performs non-medical reviews and processes redetermination letters.Description Logistics:Palmetto GBA-one of BlueCross BlueShield’s South Carolina subsidiary companies.This position is full time (40 hours/week) Monday-Friday, 8:00 AM – 5:00 PM. The role is 100% onsite and candidates may be located at either of the following locations:

• Florence: 200 Dozier Blvd, Florence, SC 29501
• Columbia: Government Programs Complex (GPC), 17 Technology Circle, Columbia, SC 29203

Please include an updated resume with your Application.

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.

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 mycareer.help@bcbssc.comor 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.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here’s moreinformation.

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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.

 

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