Appeals Coordinator

Palmetto GBA; Columbia (SC); On-site; USD 32,000 - 42,000; Full time

Benefits offered by this job

Health plans

Dental coverage

Vision coverage

401k with match

Life Insurance

Paid Time Off

On-site facilities

Education assistance

Service recognition

National discounts

Job summary

BlueCross BlueShield of South Carolina is seeking an administrative professional to maintain the proper flow of appeal requests at our Columbia, SC location. The role offers full-time hours, 8:00 AM–5:00 PM, with potential early shifts after training.

You will enter data, assemble files, log requests, and ensure quality control of appeals while coordinating with various internal teams. Proficiency in Microsoft Office and strong communication are essential.

Qualifications

• High School Diploma or equivalent required.
• 1 year administrative support/clerical experience preferred.
• Proficiency in MS Office; strong written and verbal communication.

Responsibilities

• Research requests and enter data to identify case specifics and build appeals cases.
• Log requests to functional area, generate letters, assemble files, and obtain information.
• Ensure quality control of all appeals and prepare case files for review.

Skills

Word processing

Spreadsheets

Organizational skills

Customer service

Communication skills

Judgment

Education

High School Diploma

Tools

Microsoft Office

Job description

Summary

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we’ve 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 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, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!

Position Purpose

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

Logistics

Palmetto GBA – one of BlueCross BlueShield of South Carolina’s subsidiary companies.

Government Clearance

This position requires CMS Security Clearance as it falls within a division subject to Centers for Medicare and Medicaid Services residency requirements.

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.

Location

This full-time opportunity is scheduled for 40 hours per week, Monday through Friday, from 8:00AM to 5:00PM. After successfully completing training, employees will be eligible to work between 6:00AM-9:00PM. The primary work location is at 17 Technology Circle, Columbia, SC 29203.

Sponsorship

This position is not eligible for sponsorship now or in the future.

What You’ll 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’ll Need The Following

Required Education

High School Diploma or equivalent

Required Work Experience

1 year administrative support/clerical or job related experience.

Required Skills and Abilities

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.

Our Comprehensive Benefits Package Includes The Following

We offer our employees great benefits and rewards. You will be eligible to participate in our benefits program the first of the month following 28 days of employment.

• Subsidized health plans, dental and vision coverage
• 401k retirement savings plan with company match
• Life Insurance
• Paid Time Off (PTO)
• On-site cafeterias and fitness centers in major locations
• Education Assistance
• Service Recognition
• National discounts to movies, theaters, zoos, theme parks and more

What We Can Do for You

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

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 disabilitiesand 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 [e-mail] 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 moreinformation.

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