CGS Administrators

Specialist, Appeals (Hybrid from Nashville, TN or Columbia, SC


PayCompetitive
LocationNot available
Employment typeFull-Time

This job is now closed

  • Job Description

      Req#: R1037826


      Summary

      Performs non-medical reviews and processes redetermination letters.


      Description

      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.

      Required Education: High School Diploma or equivalent

      Required Work Experience: 2 years job related field.

      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.



      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

      CGS provides services to over 20 million healthcare recipients and 85,000 healthcare professionals across the United States. With over 46 years of successful business operations in the nation’s healthcare system, our experienced staff, proven processes...