Appeals Coordinator

Summary

We are currently hiring for an Appeals Coordinator to join BlueCross BlueShield of South Carolina. In this role as Appeals Coordinator, you will be responsible for maintaining the proper flow of the request for appeals.

Why 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 largest insurance company in South Carolina … and much more. We are one of the nation’s leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are committed to the same philosophy, consider joining our team!

Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.

Description

Logistics

This position is full time (40 hours/week) Monday-Friday 8:00-4:30 at the Government Programs Complex.

What You Will Do

• Researches requests, enters 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.
• Ensures quality control of all appeals on the appeals system, pends documents to be saved electronically, and prepares case files for review and/or further routing.
  
  

To Qualify For This Position, You Will Need

• High School Diploma or equivalent
• 1 year administrative support/clerical or job related experience.
• Demonstrated proficiency in word processing and spreadsheet software.
• Effective organizational and customer service skills.
• Good judgment skills.
• Proficiency in spelling, punctuation, and grammar skills.
• Demonstrated written and verbal communication skills.
• Required Software and Tools: Microsoft Office.
  
  

What We Prefer

• 3 years-claims, customer service or healthcare program management.
• Ability to persuade, negotiate, or influence.
• Knowledge of Microsoft Access or other database software.
• Medicare Part A experience
• FISS experience
• IFLOW experience
  
  

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.
  
  

What To Expect Next

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and salary requirements.

Management will be conducting interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

Some states have required notifications. Here's more information.

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 minorities, females, disabled individuals and 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 physical and mental disabilities.

If you need special assistance or an accommodation while seeking employment, please e-mail [email protected] or call 1-800-288-2227, 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.