BlueCross BlueShield of South Carolina

SummaryManages a team of associates responsible for the accurate and timely processing and adjudication of claims.DescriptionLogistics: Palmetto GBA one of BlueCross BlueShields South Carolina subsidiary companies.Location: This position is full-time (40-hours/week) Monday-Friday in

SummaryManages a team of associates responsible for the accurate and timely processing and adjudication of claims.DescriptionLogistics: Palmetto GBA one of BlueCross BlueShields South Carolina subsidiary companies.Location: This position is full-time (40-hours/week) Monday-Friday in

SummaryJob Description 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 BlueCr

SummaryJob Description 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 BlueCr

SummaryOversees an area responsible for claims appeals and/or customer service to ensure departmental performance guarantees are met.DescriptionLogistics: National Alliance - one of BlueCross BlueShields South Carolina subsidiary companies.Location: This position is full-time (40-hou

SummaryOversees an area responsible for claims appeals and/or customer service to ensure departmental performance guarantees are met.DescriptionLogistics: National Alliance - one of BlueCross BlueShields South Carolina subsidiary companies.Location: This position is full-time (40-hou

SummaryOversees the accurate processing of claims that have been deferred for medical necessity review. Ensures compliance with nationally recognized standards and local state and federal laws and regulations. Identifies and implements process improvement opportunities.DescriptionWhy

SummaryOversees the accurate processing of claims that have been deferred for medical necessity review. Ensures compliance with nationally recognized standards and local state and federal laws and regulations. Identifies and implements process improvement opportunities.DescriptionWhy

SummaryPerforms validation reviews of Diagnosis Related Groups (DRG) Ambulatory Procedure Codes (APC) and Never Events (serious preventable medical errors) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trend

SummaryPerforms validation reviews of Diagnosis Related Groups (DRG) Ambulatory Procedure Codes (APC) and Never Events (serious preventable medical errors) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trend

SummaryCompanion Data Services provides leading IT solutions and managed services. We operate multiple geographically disperse data centers including two of the nations largest healthcare data centers both rated among the top five percent of data centers worldwide by MIPS.With three

SummaryCompanion Data Services provides leading IT solutions and managed services. We operate multiple geographically disperse data centers including two of the nations largest healthcare data centers both rated among the top five percent of data centers worldwide by MIPS.With three

SummaryMonitor and/or reconcile assigned general ledger accounts of a complex nature process complex accounting activity resolve variances and/or document procedures to ensure accuracy of accounting information and/or financial reports and/or compliance with established rules and/or r

SummaryMonitor and/or reconcile assigned general ledger accounts of a complex nature process complex accounting activity resolve variances and/or document procedures to ensure accuracy of accounting information and/or financial reports and/or compliance with established rules and/or r

SummaryDesigns technical onboarding training staff development courses refresher trainings just-in-time trainings operational updates and coaching for a diverse audience of employees. Designs and renovates various training programs. May act in a lead role for departmental efforts and

SummaryDesigns technical onboarding training staff development courses refresher trainings just-in-time trainings operational updates and coaching for a diverse audience of employees. Designs and renovates various training programs. May act in a lead role for departmental efforts and

SummaryIndependently investigates evaluates and negotiates the resolution of assigned claims within approved authority. Responsible for making recommendations for claim outcomes on claims exceeding level of authority.DescriptionWhy should you join the BlueCross BlueShield of South Car

SummaryIndependently investigates evaluates and negotiates the resolution of assigned claims within approved authority. Responsible for making recommendations for claim outcomes on claims exceeding level of authority.DescriptionWhy should you join the BlueCross BlueShield of South Car

SummaryWe are currently hiring for a Claims Customer Service Advocate I to join BlueCross BlueShield of South Carolina. You will be responsible for responding to routine inquiries. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Revi

SummaryWe are currently hiring for a Claims Customer Service Advocate I to join BlueCross BlueShield of South Carolina. You will be responsible for responding to routine inquiries. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Revi

SummaryConducts primary/secondary market research to be used in development of new products/programs. Provides information in concise/well-written reports to assist in strategic/marketing plan. Implements and manages after launch major marketing projects makes recommendations on produ

SummaryConducts primary/secondary market research to be used in development of new products/programs. Provides information in concise/well-written reports to assist in strategic/marketing plan. Implements and manages after launch major marketing projects makes recommendations on produ

SummaryResponsible for effective and efficient recruitment activities. Maintains active requisition load for high volume repetitive jobs campus recruiting internships and/or entry-level professional roles. Fills open positions while remaining compliant with corporate policies and pro

SummaryResponsible for effective and efficient recruitment activities. Maintains active requisition load for high volume repetitive jobs campus recruiting internships and/or entry-level professional roles. Fills open positions while remaining compliant with corporate policies and pro

SummaryDescriptionWhy 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 large

SummaryDescriptionWhy 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 large

SummaryEstablishes and maintains positive relationships with network hospitals physician and/or dental practices and their representatives. Serves as point of contact for provider problems/issues. Responds to non-routine or difficult problems/issues related to network contracts reimbu

SummaryEstablishes and maintains positive relationships with network hospitals physician and/or dental practices and their representatives. Serves as point of contact for provider problems/issues. Responds to non-routine or difficult problems/issues related to network contracts reimbu

SummaryThe Workforce Manager oversees a team dedicated to optimizing performance and maintaining service levels across all customer service centers. The WF Manager will act as a liaison with overall business leaders to promote transparency between shared services business units ensuri

SummaryThe Workforce Manager oversees a team dedicated to optimizing performance and maintaining service levels across all customer service centers. The WF Manager will act as a liaison with overall business leaders to promote transparency between shared services business units ensuri

SummaryResponsible for maintaining the proper flow of the request for appeals.DescriptionLogistics: Palmetto GBA - a BlueCross BlueShield of South Carolina subsidiary company.Please submit your application along with an updated resume for consideration.This position requires CMS Secur

SummaryResponsible for maintaining the proper flow of the request for appeals.DescriptionLogistics: Palmetto GBA - a BlueCross BlueShield of South Carolina subsidiary company.Please submit your application along with an updated resume for consideration.This position requires CMS Secur

SummaryWe are currently hiring for a Quality Nurse Navigator to join BlueCross BlueShield of South this role as a Quality Nurse Navigator you will monitor/implement quality improvement/management activities conduct specific medical reviews as necessary analyze findings make recommend

SummaryWe are currently hiring for a Quality Nurse Navigator to join BlueCross BlueShield of South this role as a Quality Nurse Navigator you will monitor/implement quality improvement/management activities conduct specific medical reviews as necessary analyze findings make recommend

SummaryWorking at CGS AdministratorsCGS Administrators LLC (CGS) is part of BCBSSCs Celerian Group of companies and provides a variety of services for Medicare beneficiaries healthcare providers and medical equipment suppliers in 38 states supporting the needs of over 8.7 million Medi

SummaryWorking at CGS AdministratorsCGS Administrators LLC (CGS) is part of BCBSSCs Celerian Group of companies and provides a variety of services for Medicare beneficiaries healthcare providers and medical equipment suppliers in 38 states supporting the needs of over 8.7 million Medi

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics:CGS ()one of BlueCross BlueShields South Carolina subsidiary companies.Location:This position is full-time (40-hours/week) Monday-Friday You will work an 8-hour shift scheduled during our normal b

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics:CGS ()one of BlueCross BlueShields South Carolina subsidiary companies.Location:This position is full-time (40-hours/week) Monday-Friday You will work an 8-hour shift scheduled during our normal b

SummaryResponsible for submitting stop loss claim packets and responding to any requests for additional information. Additionally the claims must be tracked and monitored. Complex analysis is performed and queries are generated to file and validate the claim submissions.DescriptionPos

SummaryResponsible for submitting stop loss claim packets and responding to any requests for additional information. Additionally the claims must be tracked and monitored. Complex analysis is performed and queries are generated to file and validate the claim submissions.DescriptionPos