Jobs at BlueCross BlueShield of South Carolina (Now Hiring) — 92 open

Developer IV - CGS Administrators, LLC (Nashville, TN)

Nashville, Tennessee, United States · Hybrid

Senior

Summary CGS Administrators, LLC (CGS) is part of BCBSSC™'s Celerian Group of companies and provides a variety of services for Medicare beneficiaries, healthcare providers, and medical equipment suppliers in 38 states, su…

Skills: C#, MS SQL, OnBase, System development lifecycle, Application development

Operations Manager-2

Florence, South Carolina, United States · On-site

Mid level

Summary Manages the daily activities of a multi-functional area. Responsible for monitoring productivity, attendance and quality of work produced. Responsible for motivating associates to meet individual and departmental…

Skills: Management, Organization, Communication, Decision-making, Analytical skills

Customer Service Advocate II

Columbia, South Carolina, United States · On-site

Entry level

Summary Provides prompt, accurate, thorough and courteous responses to all customer inquiries. Inquiries may be non-routine and require deviation from standard screens, scripts, and procedures. Performs research as neede…

Skills: Customer service, Claims processing, Appeals processing, Verbal communication, Written communication

Appeals Coordinator

Columbia, South Carolina, United States · On-site

Entry level

Summary 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 em…

Skills: Word processing, Spreadsheet software, Organizational skills, Customer service, Judgment skills

Operations Manager-2

Florence, South Carolina, United States · On-site

Mid level

Summary Manages the daily activities of a multi-functional area. Responsible for monitoring productivity, attendance and quality of work produced. Responsible for motivating associates to meet individual and departmental…

Skills: Management, Organization, Communication, Decision-making, Analytical skills

Technician, Data Preparation Senior

Columbia, South Carolina, United States · Hybrid

Senior

Summary Performs advanced, varied clerical duties in accordance with standard procedures. This includes clerical duties such as photocopying, compiling records, filing, tabulating, posting information, and distributing m…

Skills: Clerical duties, Data entry, Scanning, Indexing, Imaging

FCMB Claims Customer Service Advocate II

Columbia, South Carolina, United States · On-site

Entry level

Summary Responsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. De…

Skills: Claims processing, Appeals processing, Customer service, Verbal communication, Written communication

Financial Analyst

Columbia, South Carolina, United States · On-site

Senior

Summary Extracts and reports enrollment and financial data used to develop competitive rates to achieve financial targets and reach profitability goals. Description Why should you join the BlueCross BlueShield of South C…

Skills: Financial analysis, Reporting, Actuarial modeling, Data extraction, Competitive pricing

Technician, Accounting III

Columbia, South Carolina, United States · On-site

Mid level

Summary Description 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 roo…

Skills: Accounting, Inventory balancing, Reconciliations, Disbursements, Deposits

Processor, Claims I

Myrtle Beach, South Carolina, United States · On-site

Entry level

Summary Responsible for the accurate and timely processing of claims. Description Logistics: PGBA – one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is full-time (40-hours/week) …

Skills: Claims processing, Analytical skills, Organizational skills, Customer service, Oral communication

Processor, Claims I

Myrtle Beach, South Carolina, United States · On-site

Entry level

Summary Responsible for the accurate and timely processing of claims. Description Logistics: PGBA – one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is full-time (40-hours/week) …

Skills: Claims processing, Analytical skills, Organizational skills, Customer service, Oral communication

Claims Customer Service Advocate II

Columbia, South Carolina, United States · On-site

Mid level

Summary Responsible for responding to customer inquiries. Inquiries may be non-routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Reviews and a…

Skills: Customer service, Claims processing, Appeals processing, Verbal communication, Written communication

FCMB Claims Customer Service Advocate II

Columbia, South Carolina, United States · On-site

Entry level

Summary Responsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. De…

Skills: Claims processing, Appeals processing, Customer service, Verbal communication, Written communication

Provider Audit Specialist - LPN or RN

Columbia, South Carolina, United States · Hybrid

Mid level

Summary Prepares for and performs institutional audits to assess appropriate provider billing and to identify any aberrant billings that may have an impact on reimbursement. Responsible for reviewing all aspects of claim…

Skills: Medical auditing, Clinical nursing, Claim processing, Medical terminology, Anatomy and physiology

Appeals Specialist

Nashville, Tennessee, United States · On-site

Mid level

Summary We are currently hiring a Part A/HHH Appeals Specialist at one of our subsidiary companies called CGS Administrators. CGS has been a proven provider of administrative and business services for state Medicaid agen…

Skills: Word processing, Spreadsheet software, Organizational skills, Customer service, Written communication

Quality Assurance Analyst

Florence, South Carolina, United States · On-site

Entry level

Summary Under direct supervision, performs quality control audits, reviews, or monitoring of departmental operations functions including, but not limited to, claims, membership, customer service/call center, workflow, pr…

Skills: Quality assurance, Auditing, Claims processing, Customer service, Data analysis

Senior Quality Assurance Analyst

Myrtle Beach, South Carolina, United States · On-site

Mid level

Summary Performs quality control audits to evaluate accuracy and effectiveness of departmental operations functions including, but not limited to, claims, membership, customer service/call center, workflow, processing su…

Skills: Quality audits, Analytical skills, Presentation skills, Customer service, Persuasion

Representative, Provider Relations

Columbia, South Carolina, United States · On-site

Mid level

Summary Provides education and training support for network providers, staff, suppliers, physicians, beneficiaries, referral agents as necessary. Develops and produces training and educational materials. Description Logi…

Skills: Training materials development, Classroom presentations, Word processing, Spreadsheet software, Customer service

Coordinator, Managed Care II/UM-1

South Carolina, United States · Remote Solely

Mid level

Summary Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests or p…

Skills: Utilization review, Case management, Clinical criteria evaluation, Medical necessity assessment, Claims knowledge

Benefit Files Analyst I

Columbia, South Carolina, United States · On-site

Mid level

Summary Under general supervision, responsible for interpreting, reviewing, and analyzing benefit plan designs. Responsible for creating scope, design and specification documents for programming of benefits from benefit …

Skills: Systems analysis, Statistical analysis, Claims processing, Computer programming, Analytical skills

About BlueCross BlueShield of South Carolina

South Carolina’s largest and oldest health insurance company

Industry
Insurance
Company size
10,001+ employees
Founded
1946
Headquarters
Columbia, South Carolina
LinkedIn followers
52,584

For more than six decades, BlueCross BlueShield of South Carolina has been part of the national landscape. Our roots are firmly embedded in the state. We are the largest insurance company in South Carolina. We are also the only one that has an A+ Superior A.M. Best rating. We are one of the nation's leading government contract administrators. We operate one of the most sophisticated data processing centers in the Southeast and have a diverse family of subsidiary companies. Our full-time employees enjoy benefits like a 401(k) retirement savings plan with company match, subsidized health plans, free vision coverage, life insurance, paid annual leave and holidays, wellness programs and education assistance. If you are a full-time employee in the National Guard or reserves, we will cover the difference in your pay if you are called to active duty. BlueCross has a dedicated corporate culture of community support. Our employees are some of the most giving in the country. They support dozens of nonprofit organizations every year. If you're ready to join a diverse company with secure, community roots and an innovative future, apply for a position now! BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association. We are an Equal Opportunity Employer. We will consider all qualified applicants for employment 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.

Offices: I-20 E at Alpine Road, Columbia, South Carolina 29219, US

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