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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 our roots firmly embedded in the South Carolina community. We are the largest insurance company in

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 embedded in the South Carolina community. We are the largest insurance company in

Summary Senior level position focused on improving provider data quality by auditing the work of Provider Enrollment Analysts and Senior Provider Enrollment Analysts. Develops reports to keep management informed of the overall quality control of Provider Information Management Systems (PIMS). Perfor

Summary Provides education and training for network providers, staff, suppliers, physicians, beneficiaries, and referral agents as necessary. Develops and produces all training and educational materials. Description Logistics: Palmetto GBA– one of BlueCross BlueShield's South Carolina subsidiary com

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. Responds to non-routine or difficult problems/issues related to network contracts, reimbursement met

Summary Responsible for creating database reports based on the needs of end users. Retrieves and manipulates data using various data manipulation and extraction techniques. Analyzes current reporting methodologies. Description Logistics: Palmetto GBA– one of BlueCross BlueShield's South Carolina sub

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 staff members. Description Why should you join the BlueCross BlueShield of South Carolina family of com

Summary We're hiring a Senior Product Designer to join our Digital Experience team. The work will primarily be for our health insurance portal and app, used by members across the country.This is a generalist role requiring a breadth of skills. You’ll work closely with the Digital Implementation Lead

Summary Provides education to medical providers as warranted. Description Logistics: Palmetto GBA– one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This is a full-time remote position. You must reside in Alabama, Georgia, or Tennessee. You will work an 8-hour shift schedu

Summary We are currently hiring for a Claims Processor I to join BlueCross BlueShield of South Carolina. You will be responsible for the accurate and timely processing of claims. Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for

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 our roots firmly embedded in the South Carolina community. We are the largest insurance company in

Summary Join our team serving active and retired US military members and their covered family members. We strive to ensure that these dedicated individuals and their loved ones receive high-quality care administered as economically as possible and in accordance with current evidence-based care guide

Summary Responsible for establishing and maintaining certification and/or preparation, review and/or maintenance of healthcare provider files in support of provider directories, accurate/timely claims adjudication, and provider billing.Why should you join the BlueCross BlueShield of South Carolina f

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) Monday-Friday from 8am-5pm in a typical office environment. This role is located

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. Description Logistics: PGBA – is a subsidiary company of BlueCross BlueShield of S

Summary We are currently hiring for an Intensive Care Management Coordinator to join BlueCross BlueShield of South Carolina. In this role as an Intensive Care Management Coordinator, you will serve as an Intensive Case Manager (ICM) for members identified with specific conditions and assist with imp

Summary Performs medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization

Summary This high-level proposal resource will participate in winning and retaining large clients, primarily designated to strategic RFPs and RFIs with a focus on strategy, storytelling, and high-quality responses. This role will collaborate with sales and account management resources to develop SWO

Summary Provides prompt, accurate, thorough and courteous responses to all customer inquiries. Performs research as needed to resolve inquiries. Description Logistics: Planned Administrators Inc. (PAI) – One of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is fu

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) Monday-Friday from 8am-5pm in a typical office environment. This role is located