Appeals Specialist — Non-Medical Reviews

033 Palmetto GBA; Columbia (SC); Presencial; USD 42.000 - 54.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Subsidized health plans

Dental and vision coverage

401k retirement savings with company"s

Life Insurance

Paid Time Off (PTO)

On-site cafeterias and fitness centers

Education Assistance

Service Recognition

National discounts

Descripción de la vacante

BlueCross BlueShield of South Carolina is seeking an Appeals Specialist to perform non-medical reviews and process redetermination letters. The role involves workload analysis, reporting, and ensuring accuracy across multiple software tools.

It requires CMS security clearance and supports a 40-hour work week at our Columbia, SC location. The position emphasizes strong communication, organizational, and documentation skills, with benefits including health plans, retirement options, and

Formación

• High School Diploma or equivalent.
• 2 years job related field experience.
• Proficiency in word processing and spreadsheet software.
• Excellent organizational, customer service, and written and verbal communication skills.
• Good judgment in decision making; strong spelling, punctuation, and grammar.

Responsabilidades

• Performs non-medical reviews and processes redetermination letters ensuring timeliness and accuracy.
• Prepares unit reports, analyzes workload, and processes issues using various software tools.
• Updates letters and documents within the department when necessary.
• May gather and prepare documentation for legal inquiries and administrative requests.

Conocimientos

Word processing

Spreadsheet software

Organizational skills

Customer service

Written and verbal communication

Good judgment

Spelling and grammar

MS Office

Educación

High School Diploma or equivalent

Herramientas

Microsoft Office

Descripción del empleo

BlueCross BlueShield of South Carolina is seeking an Appeals Specialist to perform non-medical reviews and process redetermination letters. The role involves workload analysis, reporting, and ensuring accuracy across multiple software tools.

It requires CMS security clearance and supports a 40-hour work week at our Columbia, SC location. The position emphasizes strong communication, organizational, and documentation skills, with benefits including health plans, retirement options, and