Appeals Manager

• →Provides management oversight of departmental staff and programs.
• →Ensures compliance with Center for Medicare and Medicaid Services (CMS) guidelines and performance standards.
• →Collaborates with other functional areas to resolve multifunctional issues
• →Participates in special projects as assigned

To Qualify For This Position, You'll Need The Following:

Required Education: Bachelor's

Required Work Experience: 5 years in leadership position responsible for staff management in Medicare or similar environment or equivalent military experience in grade E4 or above.

Required Skills and Abilities: Excellent verbal and written communication skills. Excellent judgment, organizational, customer service, analytical/critical thinking skills. Proficiency in grammar, spelling, punctuation skills. Basic business math proficiency. Ability to handle confidential or sensitive information with discretion. Working knowledge of word processing, spreadsheet software.

Required Software and Other Tools: Microsoft Office.

 We Prefer That You Have The Following:

• →Bachelor's degree-Business Administration, Business Management, Healthcare Administration, or related field.
• →7 years-in leadership position responsible for staff management in Medicare environment or equivalent military experience in grade E4 or above; experience to also include claims, medical affairs, or provider network experience.
• →Ability to use complex mathematical calculations. Knowledge of mathematical or statistical concepts. Knowledge of database software.

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

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 those candidates who are the most qualified, with prioritization given to those candidates who demonstrate the required qualifications.

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 individuals with disabilities and protected 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 disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 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.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information.

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