BlueCross BlueShield of South Carolina

SummarySenior level position focused on improving provider data quality by auditing the work of Provider Enrollment Analysts and Senior Provider Enrollment Analysts. Develops reports to keep management informed of the overall quality control of Provider Information Management Systems

SummarySenior level position focused on improving provider data quality by auditing the work of Provider Enrollment Analysts and Senior Provider Enrollment Analysts. Develops reports to keep management informed of the overall quality control of Provider Information Management Systems

SummaryWe have a job opening for the Marketing Summer Student Intern at CDS a subsidiary of BlueCross BlueShield of South Carolina. The Intern position is utilized for training an active high school or college student towards an entry level role. The responsibilities vary and are bas

SummaryWe have a job opening for the Marketing Summer Student Intern at CDS a subsidiary of BlueCross BlueShield of South Carolina. The Intern position is utilized for training an active high school or college student towards an entry level role. The responsibilities vary and are bas

SummaryResponsible for the maintenance of records and the processing of claims in medical review along with any and/or all of the following: processes ingoing/outgoing mail and prepares work for nursing staff. Troubleshoots claims prior to nurse review and after review. Monitors ti

SummaryResponsible for the maintenance of records and the processing of claims in medical review along with any and/or all of the following: processes ingoing/outgoing mail and prepares work for nursing staff. Troubleshoots claims prior to nurse review and after review. Monitors ti

SummaryPosition PurposeWe are hiring a Project Manager! In this role you will be responsible for the management of area projects. You will focus on meeting project commitments including communications with sponsors stakeholders etc. As assigned lead or assist in the planning implement

SummaryPosition PurposeWe are hiring a Project Manager! In this role you will be responsible for the management of area projects. You will focus on meeting project commitments including communications with sponsors stakeholders etc. As assigned lead or assist in the planning implement

SummaryAs member of the senior management team provides administrative oversight to the medical staff analyzes medical review utilization data researches new medical procedures or technology and acts as a resource to providers and internal staff on issues concerning medical policies.

SummaryAs member of the senior management team provides administrative oversight to the medical staff analyzes medical review utilization data researches new medical procedures or technology and acts as a resource to providers and internal staff on issues concerning medical policies.

SummaryResponsible for the maintenance of records and the processing of claims in medical review along with any and/or all of the following: processes ingoing/outgoing mail and prepares work for nursing staff. Troubleshoots claims prior to nurse review and after review. Monitors ti

SummaryResponsible for the maintenance of records and the processing of claims in medical review along with any and/or all of the following: processes ingoing/outgoing mail and prepares work for nursing staff. Troubleshoots claims prior to nurse review and after review. Monitors ti

SummaryResponsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions.DescriptionLogistics: PGBA is a subsidiary company of BlueCross Blue

SummaryResponsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions.DescriptionLogistics: PGBA is a subsidiary company of BlueCross Blue

SummaryResponsible for auditing group (small/large/complex) accounts to ensure premium payments and/or reimbursements are processed/reported in timely/accurate manner. Audits subscriber accounts to ensure premium payments are within grace period. Resolves billing/payment problems adju

SummaryResponsible for auditing group (small/large/complex) accounts to ensure premium payments and/or reimbursements are processed/reported in timely/accurate manner. Audits subscriber accounts to ensure premium payments are within grace period. Resolves billing/payment problems adju

SummaryPerforms non-medical reviews and processes redetermination letters.DescriptionLocation : This position is hybrid schedule 3 days onsite reporting at 26 Century Blvd Suite ST610Nashville TN 37214 and two days remote this is a full time role (40 hours/week) Monday-Friday.As an Ap

SummaryPerforms non-medical reviews and processes redetermination letters.DescriptionLocation : This position is hybrid schedule 3 days onsite reporting at 26 Century Blvd Suite ST610Nashville TN 37214 and two days remote this is a full time role (40 hours/week) Monday-Friday.As an Ap

SummaryWe are seeking a driven relationship-focused Employee Benefit Sales Professional to join our team. This individual will play a key role in expanding our client base fostering existing relationships and serving as a trusted advisor to our partners. The ideal candidate is highly

SummaryWe are seeking a driven relationship-focused Employee Benefit Sales Professional to join our team. This individual will play a key role in expanding our client base fostering existing relationships and serving as a trusted advisor to our partners. The ideal candidate is highly

SummaryResponsible for providing a full range of compliance and operational audits business advisory and consultation services investigations internal controls accountability and use of resources.DescriptionThe Auditor is responsible for providing a full range of compliance and opera

SummaryResponsible for providing a full range of compliance and operational audits business advisory and consultation services investigations internal controls accountability and use of resources.DescriptionThe Auditor is responsible for providing a full range of compliance and opera

SummaryResponsible for responding to routine inquiries. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return deny or pay claims following organizatio

SummaryResponsible for responding to routine inquiries. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return deny or pay claims following organizatio

SummaryDescriptionWhy should you join the BlueCross BlueShield of South Carolina family of companies Other companies come and go but weve been part of the national landscape for more than seven decades with our roots firmly embedded in the South Carolina community. We are the largest

SummaryDescriptionWhy should you join the BlueCross BlueShield of South Carolina family of companies Other companies come and go but weve been part of the national landscape for more than seven decades with our roots firmly embedded in the South Carolina community. We are the largest

SummaryResponsible for providing a full range of financial compliance and operational audits business advisory and consultation services investigations internal controls accountability and use of resources.DescriptionThe Auditor is responsible for providing a full range of compliance

SummaryResponsible for providing a full range of financial compliance and operational audits business advisory and consultation services investigations internal controls accountability and use of resources.DescriptionThe Auditor is responsible for providing a full range of compliance

SummaryDescriptionLocation:This role is onsite at our Myrtle Beach SC location. Fulltime 40 hours/weekGovernment Clearance: This position requires the ability to obtain a security clearance which requires applicants to be a U.S. Citizen.SCA Benefit Requirements: BlueCross BlueShield o

SummaryDescriptionLocation:This role is onsite at our Myrtle Beach SC location. Fulltime 40 hours/weekGovernment Clearance: This position requires the ability to obtain a security clearance which requires applicants to be a U.S. Citizen.SCA Benefit Requirements: BlueCross BlueShield o

SummaryWhy should you join the BlueCross BlueShield of South Carolina family of companies Other companies come and go but weve been part of the national landscape for more than seven decades with our roots firmly embedded in the South Carolina community. We are the largest insurance c

SummaryWhy should you join the BlueCross BlueShield of South Carolina family of companies Other companies come and go but weve been part of the national landscape for more than seven decades with our roots firmly embedded in the South Carolina community. We are the largest insurance c

SummaryProvides supervision of staff performing quality control activities for department or line business.DescriptionLogistics: National Alliance one of BlueCross BlueShields South Carolina subsidiary companies.Location: This hybrid position is full-time (40-hours/week) Monday-Frida

SummaryProvides supervision of staff performing quality control activities for department or line business.DescriptionLogistics: National Alliance one of BlueCross BlueShields South Carolina subsidiary companies.Location: This hybrid position is full-time (40-hours/week) Monday-Frida

SummaryAnalyzes current and proposed policies procedures systems forms and reports for the department. Analyzes existing processes and procedures to recommend operational improvement through standardization simplification discontinuance or other methods. May recommend installations o

SummaryAnalyzes current and proposed policies procedures systems forms and reports for the department. Analyzes existing processes and procedures to recommend operational improvement through standardization simplification discontinuance or other methods. May recommend installations o

SummaryWe 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 Bl

SummaryWe 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 Bl

SummaryWhy should you join the BlueCross BlueShield of South Carolina family of companies Other companies come and go but weve been part of the national landscape for more than seven decades with our roots firmly embedded in the South Carolina community. We are the largest insurance c

SummaryWhy should you join the BlueCross BlueShield of South Carolina family of companies Other companies come and go but weve been part of the national landscape for more than seven decades with our roots firmly embedded in the South Carolina community. We are the largest insurance c