Appeals Coordinator

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!

About the Role

An Appeals Coordinator is responsible for maintaining the proper flow of the request for appeals.

This position is with Palmetto GBA, one of BlueCross BlueShield's South Carolina subsidiary companies. This is a full-time, onsite role located at the Government Program Complex (GPC), 17 Technology Circle, Columbia, SC 29203. This position requires CMS Security Clearance as it falls within a division subject to Centers for Medicare and Medicaid Services residency requirements. This position is not eligible for sponsorship now or in the future.

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.

Requirements

• High School Diploma or equivalent.
• 1 year of administrative support/clerical or job-related experience.

Skills

• Demonstrated proficiency in word processing and spreadsheet software.
• Effective organizational and customer service skills.
• Good judgment skills.
• Proficiency in spelling, punctuation, and grammar.
• Demonstrated written and verbal communication skills.
• Microsoft Office skills.

Schedule

Full-time position (40 hours/week, Monday – Friday, work hours between 7:00 am – 7:45 pm).

Benefits

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits 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.

As a Service Contract Act (SCA) employee, you are required to enroll in our health insurance, even if you already have other health insurance. Until your enrollment is complete, you will receive supplemental pay for health coverage. Your coverage begins on the first day of the month following 28 days of full-time employment.