Appeals Coordinator

033 Palmetto GBA; United States; Hybrid; USD 32,000 - 46,000; Full time

Benefits offered by this job

Health insurance

401k with company match

Life Insurance

Paid Time Off

Job summary

Palmetto GBA, a BlueCross BlueShield of South Carolina subsidiary, is seeking a detail-oriented professional to maintain the proper flow of requests for appeals. The role is full-time with a 40-hour week and a hybrid schedule after training, including home-based Mondays and Fridays. Location is Columbia, SC, with a standard 7:00 a.m.–7:45 p.m.

shift window and occasional overtime. The position requires a high school diploma, 1 year of admin support, and strong MS Office skills for data entry,

Qualifications

• High School Diploma or equivalent required.
• 1 year administrative support/clerical or job related experience.
• Proficiency in word processing and spreadsheet software.
• Demonstrated written and verbal communication skills.

Responsibilities

• 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.

Skills

Word processing

Spreadsheet skills

Organizational skills

Customer service

Communication skills

Attention to detail

Spelling and grammar

Written and verbal communication

Microsoft Office

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

Summary

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 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!

Description

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.

Location: This is a full-time position (40 hours per week), with a Monday through Friday schedule. After completing training, you will transition to a hybrid work arrangement, working from home on Mondays and Fridays. You will work an 8-hour shift scheduled within the department's standard business hours of 7:00 a.m. to 7:45 p.m. Occasional overtime may be required based on business needs. This position is located at 17 Technology Circle, Columbia, SC 29203.

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.

Required Qualifications

• 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

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 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 [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.

About Palmetto GBA

Palmetto GBA is a healthcare service administrator and one of the nation’s largest providers of high-volume medical claims and transaction processing. We provide services and technology solutions to improve and streamline healthcare administration not only for government but also for corporate entities. We offer a wide range of services that require a diverse workforce and expansive areas of expertise from data analytics, administrative and workflow services to advanced systems. To help our associates succeed and reach their professional goal, we offer training classes and programs that help employees prepare for leadership positions and offer tuition assistance for education advancement. Palmetto GBA acknowledges associates’ hard work and dedication with awards and financial incentives.