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As an Appeals Specialist, you will perform non-medical reviews and process redetermination letters, ensuring accuracy and timeliness. Your duties include preparing unit reports, analyzing workload, and utilizing various software tools to manage documentation and customer inquiries.
The Data Analysis Manager is responsible for overseeing a team of analysts, ensuring the timely and accurate generation of data reports and dashboards used for business decisions. Key duties include processing complex analytical requests, coordinating data transfers, and participating in committees. The role demands strong leadership, analytical skills, and proficiency in statistical concepts.
The Accountant IV position involves maintaining ledger accounts, developing financial statements, and analyzing complex financial data. Responsibilities include preparing journal entries, reconciling accounts, researching expenses, and assisting in budgeting for departments. This role requires using various software applications for data manipulation and providing training for less experienced staff.
The Stop Loss Accounting Analyst at BlueCross BlueShield of South Carolina is responsible for submitting stop loss claim packets, tracking claims, performing complex analysis, and generating queries. The role also involves auditing stop loss positions, responding to audit letters, and ensuring accurate tracking of stop loss positions. The ideal candidate should have 3 years of experience in accounting, auditing, billing, claims, membership, or finance, along with strong organizational and communication skills.
The Provider Enrollment Analyst is responsible for reviewing and processing provider enrollment applications, ensuring compliance with standards, maintaining provider file integrity, and communicating with internal and external customers. They assist in data entry, resolve issues, participate in special projects, and contribute to process improvements in Provider Enrollment.
As an IT Project Manager, you will coordinate project planning and execution, monitor progress, manage resources, and ensure compliance with project standards while leading multiple low complexity projects.
The Representative, Enrollment I is responsible for processing membership and enrollment applications, handling terminations and renewals, updating databases, and addressing customer inquiries. This role involves working with various operational areas, preparing contracts and ID cards, and participating in enrollment-related projects.
The Provider Contracting Manager is responsible for establishing and maintaining provider networks, managing contract negotiations, ensuring compliance with contract obligations, and conducting financial analyses of contract proposals. This role requires effective relationship management with providers and coordination with internal departments to improve operational processes and training programs.
The Provider Enrollment Analyst is responsible for reviewing, researching, analyzing, and processing provider enrollment applications, ensuring compliance and integrity of provider data. Key tasks include data entry, providing customer service, resolving discrepancies, and supporting process improvements and special projects.
The Strategic Account Executive is responsible for sales, service, and management of relationships with existing and prospective accounts, including analyzing data and market trends, mentoring team members, and managing new account sales strategies.
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