PGBA

SummaryPerforms medical reviews using established criteria sets and/or performs utilization management of professional inpatient or outpatient facility benefits or services and appeals. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and re

SummaryPerforms medical reviews using established criteria sets and/or performs utilization management of professional inpatient or outpatient facility benefits or services and appeals. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and re

SummaryResponsible for assisting in the execution of financial compliance and operational audits including evaluation of internal controls. Audits the activity of various departments and providers for compliance with plans policies and procedures prescribed by management. Reviews assi

SummaryResponsible for assisting in the execution of financial compliance and operational audits including evaluation of internal controls. Audits the activity of various departments and providers for compliance with plans policies and procedures prescribed by management. Reviews assi

SummaryProvides prompt accurate thorough and courteous responses to all customer inquiries. Performs research as needed to resolve inquiries.DescriptionLogistics: Palmetto GBA one of BlueCross BlueShields South Carolina subsidiary companies.Location:This position is Part-time (30 ho

SummaryProvides prompt accurate thorough and courteous responses to all customer inquiries. Performs research as needed to resolve inquiries.DescriptionLogistics: Palmetto GBA one of BlueCross BlueShields South Carolina subsidiary companies.Location:This position is Part-time (30 ho

SummaryProvides prompt accurate thorough and courteous responses to all complex customer inquiries. Inquiries are typically non-routine and require deviation from standard screens scripts and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates comp

SummaryProvides prompt accurate thorough and courteous responses to all complex customer inquiries. Inquiries are typically non-routine and require deviation from standard screens scripts and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates comp

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.DescriptionJob DescriptionPosition Purpose:From the moment of login y

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.DescriptionJob DescriptionPosition Purpose:From the moment of login y

SummaryWhy should you join the BlueCross BlueShield of South Carolina family of companiesOther 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 co

SummaryWhy should you join the BlueCross BlueShield of South Carolina family of companiesOther 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 co

SummaryResponsible for establishing and maintaining certification and/or preparation review and/or maintenance of healthcare provider files in support of provider directories accurate/timely claims adjudication and provider billing.Why should you join the BlueCross BlueShield of South

SummaryResponsible for establishing and maintaining certification and/or preparation review and/or maintenance of healthcare provider files in support of provider directories accurate/timely claims adjudication and provider billing.Why should you join the BlueCross BlueShield of South

SummaryManages the daily activities of a multi-functional area. Responsible for monitoring productivity attendance and quality of work produced. Responsible for motivating associates to meet individual and departmental goals.DescriptionLogistics:PGBA one of BlueCross BlueShields South

SummaryManages the daily activities of a multi-functional area. Responsible for monitoring productivity attendance and quality of work produced. Responsible for motivating associates to meet individual and departmental goals.DescriptionLogistics:PGBA one of BlueCross BlueShields South

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companies.Location: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role i

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companies.Location: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role i

SummaryProvides prompt accurate thorough and courteous responses to all customer inquiries. Performs research as needed to resolve inquiries.DescriptionJob DescriptionLogistics: Palmetto GBA one of BlueCross BlueShields South Carolina subsidiary companies.Location:This position is f

SummaryProvides prompt accurate thorough and courteous responses to all customer inquiries. Performs research as needed to resolve inquiries.DescriptionJob DescriptionLogistics: Palmetto GBA one of BlueCross BlueShields South Carolina subsidiary companies.Location:This position is f

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companiesLocation: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. It may be nec

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companiesLocation: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. It may be nec

SummaryPerforms medical reviews using established criteria sets and/or performs utilization management of professional inpatient or outpatient facility benefits or services and appeals. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and re

SummaryPerforms medical reviews using established criteria sets and/or performs utilization management of professional inpatient or outpatient facility benefits or services and appeals. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and re

SummaryReviews and adjudicates complex or specialty claims. Determines whether to return deny or pay claims following organizational policies and procedures. Assists in training or mentoring new staff members.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina sub

SummaryReviews and adjudicates complex or specialty claims. Determines whether to return deny or pay claims following organizational policies and procedures. Assists in training or mentoring new staff members.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina sub

SummaryResponsible for identifying training needs developing training materials and facilitating training. Provides training guidance and leadership for new training specialists. Develops performance assessments and testing materials. Manages trainees and communicates effectively with

SummaryResponsible for identifying training needs developing training materials and facilitating training. Provides training guidance and leadership for new training specialists. Develops performance assessments and testing materials. Manages trainees and communicates effectively with

SummaryWe have a job opening for the position of Summer Student Intern at PGBA 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

SummaryWe have a job opening for the position of Summer Student Intern at PGBA 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

SummaryUnder general supervision performs a variety of routine to moderately complex clerical/accounting functions such as inventory balancing reconciliations generating refund request letters processing disbursements and deposits keying journal entries and logging items in accordance

SummaryUnder general supervision performs a variety of routine to moderately complex clerical/accounting functions such as inventory balancing reconciliations generating refund request letters processing disbursements and deposits keying journal entries and logging items in accordance

SummaryPerforms medical reviews using established criteria sets and/or performs utilization management of professional inpatient or outpatient facility benefits or services and appeals. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and re

SummaryPerforms medical reviews using established criteria sets and/or performs utilization management of professional inpatient or outpatient facility benefits or services and appeals. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and re

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companies.Location: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role i

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companies.Location: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role i

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companies.Location: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role i

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companies.Location: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role i

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companiesLocation: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. It may be nec

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companiesLocation: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. It may be nec