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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 Responsible for maintaining the proper flow of the request for appeals.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

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

Summary Manages the provider enrollment unit ensuring the accurate and timely enrollment of providers, meeting all regulatory requirements, and maintains the national provider file database. Description Logistics: Palmetto GBA– one of BlueCross BlueShield's South Carolina subsidiary companies. Locat

Summary Responsible for providing a full range of financial, compliance, and operational audits, business advisory and consultation services, investigations, internal controls, accountability, and use of resources. Description This is a full time remote position working Monday through Friday. Conduc

Summary Researches and interprets insurance laws pertaining to division products form filings and obtains approval from the various state insurance departments. Communicates impact of insurance bulletins, circulars, and directives to appropriate departments and ensures compliance with all laws and r

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 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 Responsible for managing contract staff and administration of all contracts to ensure that contractual obligations are met and compliance is maintained with mandatory governmental regulations, applicable laws and corporate policies and procedures. Ensures effective relationships between the

Summary Responsible for providing a full range of financial, compliance, and operational audits, business advisory, and consultation services, investigations, internal controls, accountability, and use of resources. Description This is a full-time remote position working Monday through Friday 8:00am

Summary Responsible for providing a full range of financial, compliance, and operational audits, business advisory and consultation services, investigations, internal controls, accountability, and use of resources. Description This is a full-time position working in Columbia, SC. What You'll Do: Con

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