Appeals Specialists

About the role

Performs non-medical reviews and processes redetermination letters. 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.

Responsibilities

• 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
• If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or 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 more information .
• Some states have required notifications. Here's more information .

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