Appeals Specialist Jobs

Summary

We are currently hiring for an Appeals Specialist to join BlueCross BlueShield of South Carolina. In this role as Appeals Specialist, you will be required to perform non-medical reviews and process redetermination 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 nation’s 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

Logistics:

This position will be full time, Monday – Friday and held onsite at our Augusta, GA location.

What You Will Do

• Prepare unit reports, analyze, and interpret workload, and process issues utilizing various software tools.
• Perform non-medical reviews and process redetermination letters ensuring timeliness and accuracy.
• Update letters and documents within the department when necessary.
• May gather and prepare documentation for legal inquiries and administrative requests.

What You Need To Qualify

• Proficiency in spelling, punctuation, and grammar skills.
• Excellent organizational, customer service, and written and verbal communication skills.
• Demonstrated proficiency in word processing and spreadsheet software.
• High School Diploma or equivalent
• Microsoft Office.
• Two years job related field.
• Good judgment skills.

What We Can Do For You

Our comprehensive benefits package includes:

• Paid annual leave — the longer you work here, the more you earn.
• Service Recognition.
• On-site cafeterias and fitness centers in major locations.
• Subsidized health plans and free vision coverage.
• Nine paid holidays.
• 401(k) retirement savings plan with company match & annual enhancement.
• Wellness programs and a healthy lifestyle premium discount.
• Sports membership program.
• Life insurance.
• Tuition assistance.

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 our 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 E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

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 e-mail [email protected] or call 1-800-288-2227, ext. 43172 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.