• Job Description

  Req#: R1035081

  
  Summary
  

  Performs non-medical reviews and processes redetermination letters.

  
  Description
  

  Logistics:

  • Position can be work from home or in our Nashville, TN office. Must have high-speed (non-satellite) service and private home office.
  • Work hours during training: 7:30 am to 4:00 pm CT Monday through Friday
  • Work hours following training: You can start your eight-hour shift between the hours of 5:00 am and 9:00 am CT.

  What you will do:

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

  What you need to qualify:

  • High School Diploma or equivalent.
  • Two years of job experience in a related field (insurance, healthcare).

  What we prefer you have:

  • Medical claims processing, appeals, billing, or coding experience, strongly preferred.
  • Excellent computer skills with the ability to navigate between multiple software platforms and work on multiple computer screens.
  • Intermediate Excel skills.

  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 access and opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

  Our comprehensive benefits package includes:

  • 401(k) retirement savings plan with company match
  • Fantastic health plans and free vision coverage
  • Life insurance
  • Paid annual leave — the longer you work here, the more you earn
  • Nine paid holidays
  • On-site cafeterias and fitness centers in major locations
  • Wellness programs and a healthy lifestyle premium discount
  • Tuition assistance
  • Service recognition

  What to Expect Next:

  After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Management will be conducting interviews with the most qualified candidates.

  
  
  

  We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

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

  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 minorities, females, disabled individuals and 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 physical and mental disabilities.

  If you need special assistance or an accommodation while seeking employment, please e-mail mycareer.help@bcbssc.com or call 1-800-288-2227, 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.

• About the company

  When you hear "BlueCross BlueShield of South Carolina," you'll see people nodding in recognition. Most everyone knows who we are. As the only South Carolina-owned and operated health insurance carrier, we have been offering security to Palmetto State citizens for more than 70 years. We are also one of South Carolina's largest employers.

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