Specialist, Appeals - Request #37745836

Southcarolinablues; Columbia (SC); Hybrid; USD 22,000 - 23,000; Part time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401K

Job summary

BlueCross BlueShield of South Carolina is seeking a Specialist, Appeals to conduct non-medical reviews and process redetermination letters. The role involves preparing unit reports and using various software tools to analyze workload, with additional document updates and preparation for legal inquiries.

The position is a contract role with onsite work and potential for remote transition after initial training, requiring strong organizational and communication skills and a high school diploma or

Qualifications

• High School Diploma or equivalent.
• 2 years of related work experience.
• Proficiency in word processing and spreadsheet software; strong written and verbal communication.

Responsibilities

• Performs non-medical reviews and processes redetermination letters.
• 50% Performs non-medical reviews and processes redetermination letters ensuring timeliness and accuracy.
• 30% Prepares unit reports, analyzes and interprets workload, and processes issues utilizing various software tools.
• 10% Updates letters and documents within the department when necessary.
• 10% May gather and prepare documentation for legal inquiries and administrative requests.

Skills

Word processing

Spreadsheet software

Organizational skills

Customer service

Written communication

Verbal communication

Good judgment

Spelling and grammar

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

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’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. Business and political climates may change, but we’re stronger than ever. Our A.M. Best rating is A+ (Superior) — making us the only health insurance company in South Carolina with that rating. We’re 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 dedicated to the same philosophy, consider joining our team!

Job Title:Specialist, Appeals

Position Details:

• Manager will conduct a phone screen, then a possible 2nd INTV via Onsite or Teams Virtually Monday-Friday 9AM-5PM Training will be 4-6 Weeks CAN TRANSIT TO REMOTE
• Contract Position

Duties:

• Performs non-medical reviews and processes redetermination letters.
• 50% Performs non-medical reviews and processes redetermination letters ensuring timeliness and accuracy.
• 30% Prepares unit reports, analyzes and interprets workload, and processes issues utilizing various software tools.
• 10% Updates letters and documents within the department when necessary.
• 10% May gather and prepare documentation for legal inquiries and administrative requests.

Required Skills and Abilities: Demonstrated proficiency in word processing and spreadsheet software. Excellent organizational, customer service, and written and verbal communication skills. Good judgment skills. Proficiency in spelling, punctuation, and grammar skills.

Required Software and Tools: Microsoft Office.

Work Environment: Typical office environment.

Required Education: High School Diploma or equivalent

Required Work Experience: 2 years job related field.

Pay Transparency:

• This is the pay range that Magnit reasonably expects to pay someone for this position is $16.00/hour - $17.50/hour W-2.
• Benefits: Medical, Dental, Vision, 401K (provided minimum eligibility hours are met).

BlueCross is a strong supporter of our veterans, and many service men and women have joined our ranks. We’ve found the dedication, work ethic and job skills that serve well in the military excel in many of our lines of business, and we proudly have veterans filling positions in Human Resources, Information Technology, Customer Service, Operations, General Services and more.

Through our government contracts, we also have employees serving at Shaw Air Force Base, the Naval Health Clinic in Charleston, the Naval Hospital in Beaufort and in our hometown of Columbia, S.C., at Ft. Jackson.If you are a full-time employee in the National Guard or Reserves, we will even cover the difference in your pay if you are called to active duty.If you're ready to join in a diverse company with secure, community roots and an innovative future,