Appeals Specialist

Summary
 Performs non-medical reviews and processes redetermination letters.
Description
 

Logistics:

• This position is full time (40 hours/week) Monday-Friday.
• Four to six weeks of onsite training at 4101 Percival Road, Columbia SC, 29223.
• To work from home, you must have high-speed internet (non-satellite) and a private home office.
• Work Monday through Friday. Select an eight-hour shift starting between 6:00 am and 9:00 am.
• Quarterly bonus potential of $600.00

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.

To Qualify for This Position, You Will Need:

• High School Diploma or equivalent.
• Two years job-related experience (data entry, insurance, medical office or similar).
• 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.
• Microsoft Office.

What We Prefer You Have:

• Medical claims processing.

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 [email protected] 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.