Summary
 

Responsible for maintaining the proper flow of the request for appeals.

Description
 

Logistics: Palmetto GBA - one of BlueCross BlueShield's South Carolina subsidiary companies.

SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). Under the McNamara-O'Hara Service Contract Act (SCA), employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date.

Work Setting: Onsite at 200 Dozier Blvd, Florence, SC 29501 OR 17 Technology Circle, Columbia, SC 29203

Working Hours: 8:00 AM – 4:30 PM (flexible after training)

What you’ll do:

• Research requests, enter appropriate data to identify case specifics and builds appeals cases on the system.

• Logs requests to appropriate functional area, generates letters, assembles files, orders records, and obtains additional information as directed.

• Ensure quality control of all appeals on the appeals system, pend documents to be saved electronically, and prepares case files for review and/or further routing.

To Qualify for this Position, you’ll need:

• High School Diploma or equivalent

• One year of administrative support/clerical or job-related experience.

• Proficient in word processing and spreadsheet software:  Microsoft Office

• Organizational and customer service skills.

• Good judgment skills.

• Proficient in spelling, punctuation, grammar, written and verbal communication skills.

We Prefer That You Have:

• Skilled in using Excel.

• Medical claims processing, appeals, insurance or healthcare experience.

• Medicare experience

What We Can Do For You:

Our comprehensive benefits package includes:

• 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

• Wellness programs and a healthy lifestyle premium discount

• Tuition assistance

• Service recognition

• Realistic career advancement opportunities

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 individuals with disabilities and protected 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 disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email [email protected] 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.

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