BlueCross BlueShield of South Carolina
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About the Company
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.
Quick Facts
Open Positions
87Summary Under direct supervision, performs quality control audits, reviews, or monitoring of departmental operations functions including, but not limited to, claims, membership, customer service/call ...
Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with...
Summary Ensures that training and educational needs are met by developing, writing, and implementing training materials, programs and curricula for staff and customers.Description Location: This posit...
Summary Provides prompt, accurate, thorough and courteous responses to all telephone inquiries. Performs research as needed to resolve inquiries.Description Location: This position is full-time (40-ho...
Summary Responsible for identifying training needs, developing training materials and facilitating training. Provides training, guidance and leadership for new training specialists. Develops performan...
Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with...
Summary Performs medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines. Documents decisions using indicated ...
Summary Develops test plans and test matrices, conducts testing, and reports test results for system changes. Coordinates implementation and debugging of new software ensuring that the new or modified...
Summary We are currently hiring for a Managed Care Coordinator II – Utilization Management to join BlueCross BlueShield of South Carolina. In this role as a Managed Care Coordinator II – Utilization M...
Summary Provides support to the underwriting department. Reviews applications/proposals and endorsement requests from agents and performs data entry, and may provide quotes and issue policies. Analyze...
Summary Responsible in the provider enrollment process to review, research, analyze, and process provider enrollment applications. Ensures provider file integrity and that suppliers are in compliance ...
Summary Manages claims and customer service areas.Description Location: This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift schedule...
Summary Responsible in the provider enrollment process to review, research, analyze, and process provider enrollment applications. Ensures provider file integrity and that suppliers are in compliance ...
Summary Oversees an area responsible for claims, appeals, and/or customer service to ensure departmental performance guarantees are met.Description Location: This position is full-time (40-hours/week)...
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. Perfor...
Summary Designs technical onboarding training, staff development courses, refresher trainings, just-in-time trainings, operational updates, and coaching for a diverse audience of employees. Designs an...
Summary Responsible for providing a full range of financial, compliance, and operational audits, business advisory and consultation services, investigations, internal controls, accountability, and use...
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 individ...
Summary We are currently hiring for an RN Appeals Analyst to join BlueCross BlueShield of South Carolina. In this role as an RN Appeals Analyst, you will research the substance of complex appeal or re...
Summary This position completes research efficiently and accurately to ensure the departmental goals to prevent aging of claims and erroneous disbursements or claims from processing incorrectly. This ...
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...
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 inqu...
Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with...
Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with...
Summary We are currently hiring for a Workforce and Reporting Manager to join BlueCross BlueShield of South Carolina. You will be responsible for managing one or more teams responsible for customer se...
Summary Acts as Team Lead for specialty programs, medical review, utilization management, and case management areas by providing assistance and support to unit supervisor/manager by giving direction/g...
Summary Provides prompt, accurate, thorough and courteous responses to all complex customer inquiries. Inquiries are typically non-routine and require deviation from standard screens, scripts, and pro...
Summary Develops, coordinates, evaluates and supports in the administration of wellness solutions and programs within a client’s organization to promote employee health and well-being. Responsible for...
Summary We have an opening for the position of Senior Corporate Communications Writer at CGS Administrators, LLC, a subsidiary of BlueCross BlueShield of South Carolina. In this role, you will be resp...
Summary Performs medical reviews using established criteria sets and/or performs utilization management of professional, inpatient or outpatient, facility benefits or services, and appeals. Documents ...
Summary Responsible for identifying training needs, developing training materials, and facilitating training. Provides training and guidance for new training specialists. Develops performance assessme...
Summary Responsible for the accurate and timely processing of claims.Description Equal Employment Opportunity StatementBlueCross BlueShield of South Carolina and our subsidiary companies maintain a co...
Summary Responsible for providing timely, competent and professional legal assistance and support in a broad range of areas as assigned. Responsibilities may include managing litigation, handling acqu...
Summary Description Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national lan...
Summary We are currently hiring for a Behavioral Health Care Management Supervisor to join BlueCross BlueShield of South Carolina. In this role as a Behavioral Health Care Management Supervisor, you w...
Summary We are currently hiring for a Quality Nurse Navigator to join BlueCross BlueShield of South Carolina. In this role as a Quality nurse Navigator, you will monitor/implement quality improvement/...
Summary Directs the development/design of various solutions for our business to include front end electronic systems and backend processing systems, and, processes, that create cost savings through an...
Summary Responsible for providing a full range of financial, compliance, and operational audits, business advisory and consultation services, investigations, internal controls, accountability, and use...
Summary Performs front office functions. Provides executive support. Represents the company in a professional manner. Utilizes specialized knowledge, job experience, and attention to detail to handle ...
Summary Responsible for assisting in the execution of financial, compliance, and operational audits including evaluation of internal controls. Audits the activity of various departments and providers ...
Summary Provides prompt, accurate, thorough and courteous responses to all telephone inquiries. Performs research as needed to resolve inquiries.Description Location: This position is full-time (40-ho...
Summary We are currently hiring for an Appeals Analyst to join BlueCross BlueShield of South Carolina. In this role as Appeals Analyst, you will research the substance of complex appeal or retrospecti...
Summary We are currently hiring for a Case Management Coordinator to join BlueCross BlueShield of South Carolina. In this role as a Case Management Coordinator, care management interventions focus on ...
Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with...
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. Perfor...
Summary Coordinates with relevant areas to ensure customers (agents, group administrators, members, etc.) receive outstanding customer service and to ultimately retain customer base. Addresses issues ...
Summary Provides supervision and direction of the statistical reporting function and data analysis to support clinical reporting function.Description Logistics: Palmetto GBA - a subsidiary of BlueCros...
Summary We are currently hiring for a Managed Care Coordinator I to join BlueCross BlueShield of South Carolina. In this role as a Managed Care Coordinator I, you will review and evaluate medical or b...
Summary Responsible for engaging eligible individuals through outbound and inbound calls to educate them on Insurance plans, assess their needs, and complete enrollments. This role requires an active ...
Summary Responsible for the accurate and timely processing of claims.Description Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but fo...
Summary Responsible for responding to routine inquiries. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non-m...
Summary Provides education to medical providers as warranted.Description Logistics: CGS (cgsadmin.com)– one of BlueCross BlueShield's South Carolina subsidiary companies.Government Clearance: This pos...
Summary We are currently hiring for a Behavioral Health Case Management Coordinator to join BlueCross BlueShield of South Carolina. In this role as a Behavioral Health Case Management Coordinator, car...
Summary We are currently hiring for a Medical Reviewer II to join BlueCross BlueShield of South Carolina. In this role as a Medical Reviewer II, you will perform medical reviews using clinical/medical...
Summary Under general supervision, performs a variety of routine to moderately complex clerical/accounting functions such as inventory balancing, reconciliations, generating refund request letters, pr...
Summary Acts as a Team Lead by providing guidance/direction/training to Provider Enrollment Analysts and/or other Provider Enrollment area staff. Responsible for the processing of difficult enrollment...
Summary Performs non-medical reviews and processes redetermination letters.Description LocationThis position is hybrid schedule 3 days onsite reporting at26 Century Blvd Suite ST610Nashville, TN 37214...
Summary We are currently hiring for a Senior Medical Reviewer to join BlueCross BlueShield of South Carolina. In this role as a Senior Medical Reviewer, you will act as Team Lead for specialty program...
Summary Responsible for directing all contract activities to ensure that contractual obligations are met and compliance is maintained with mandatory government regulations, applicable laws and Corpora...
Summary Establishes and maintains positive relationships with network hospitals, physician and/or dental practices, and their representatives. Serves as point of contact for provider problems/issues. ...
Summary Responsible for instructional design, strategies, assessment, and innovative learning techniques. Performs in-depth analysis, design, development and delivery of learning programs that enhance...
Summary We are seeking a driven, relationship-focused Employee Benefit Sales Professional to join our team. This individual will play a key role in expanding our client base, fostering existing relati...
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...
Summary We have a job opening for the position of Accounting Business Unit Student (Year-Round) Intern at Palmetto GBA, a subsidiary of BlueCross BlueShield of South Carolina. The Intern position is u...
Summary Oversees the day-to-day underwriting operations including budget and staff planning as well as direct supervision of personnel to successfully accomplish company underwriting objectives and co...
Summary Oversees and manages utilization review and care coordination for members with autism spectrum disorder (ASD) and related behavioral health conditions. This role ensures that services are medi...
Summary Assists in membership/enrollment, billing, collections, and/or customer service aspects for assigned department(s). Responsible for providing prompt, quality processing, enrollment, customer s...
Summary Responsible for providing consultative sales and service to customers seeking health and ancillary insurance products and information. Accepts payments from customers, assists with wellness ed...
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 d...
Summary Description Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national lan...
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 d...
Summary Reviews and adjudicates complex or specialty claims. Determines whether to return, deny or pay claims following organizational policies and procedures. Assists in training or mentoring new sta...
Summary Responsible in the provider enrollment process to review, research, analyze, and process provider enrollment applications. Ensures provider file integrity and that suppliers are in compliance ...
Summary We have a job opening for the position of Accounting Business Unit Student (Year-Round) Intern at Palmetto GBA, a subsidiary of BlueCross BlueShield of South Carolina. The Intern position is u...
Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with...
Summary We are currently hiring for an RN Appeals Analyst to join BlueCross BlueShield of South Carolina. In this role as an RN Appeals Analyst, you will research the substance of complex appeal or re...
Summary Responsible for the management of area projects. Focuses on meeting project commitments, including communications with sponsors, stakeholders, etc. As assigned, leads or assists in the plannin...
Summary Responsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related repr...
Summary Responsible for entry level accounting activities relating to the maintenance of a complete and accurate general ledger and/or the resultant managerial reports and/or financial statements.Desc...
Summary Provide support to members for disease prevention and healthy promotion. Empower members to achieve optimal health and wellness by providing personalized guidance, education, and support. This...
Summary Provides intake support for the claims department. Works with a team to coordinate communications and ensure emails are reviewed, assigned or responded to timely. Reviews claim submissions for...
Summary Responsible for the accurate and timely processing of claims.Description Logistics: PGBA– one of BlueCross BlueShield's South Carolina subsidiary companiesLocation: This position is full-time ...
Summary Under general supervision, performs a variety of routine to moderately complex clerical/accounting functions such as inventory balancing, reconciliations, generating refund request letters, pr...
Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with...
Summary We are currently hiring for a Customer Service Advocate I to join BlueCross BlueShield of South Carolina. In this role as a Claims Customer Service Advocate, you will be responsible for provid...
Summary Responsible for the supervision and maintenance of the daily functions of the following areas: Utilization Review/Review Nurses, Case Management, Medical Review, Health/Disease Management, Qua...
Summary Performs advanced, varied clerical duties in accordance with standard procedures. This includes clerical duties such as photocopying, compiling records, filing, tabulating, posting information...