Coordinator, Appeals

BlueCross BlueShield of South Carolina•Florence, SC

1d•Onsite

About The Position

Summary Responsible for maintaining the proper flow of the request for appeals. Description Logistics: Palmetto GBA - one of BlueCross BlueShield's South Carolina subsidiary companies. Work Setting: Onsite at 200 Dozier Blvd, Florence, SC 29501 weather or 17 Technology Circle, Columbia, SC 29203 Working Hours: 8:00 AM – 4:30 PM (flexible after training) What you’ll do: Research requests, enter appropriate data to identify case specifics and builds appeals cases on the system. Logs requests to appropriate functional area, generates letters, assembles files, orders records, and obtains additional information as directed. Ensure quality control of all appeals on the appeals system, pend documents to be saved electronically, and prepares case files for review and/or further routing.

Requirements

High School Diploma or equivalent
One year of administrative support/clerical or job-related experience.
Proficient in word processing and spreadsheet software: Microsoft Office
Organizational and customer service skills.
Good judgment skills.
Proficient in spelling, punctuation, grammar, written and verbal communication skills.

Nice To Haves

Skilled in using Excel.
Medical claims processing, appeals, insurance or healthcare experience.
Medicare experience

Responsibilities

Research requests, enter appropriate data to identify case specifics and builds appeals cases on the system.
Logs requests to appropriate functional area, generates letters, assembles files, orders records, and obtains additional information as directed.
Ensure quality control of all appeals on the appeals system, pend documents to be saved electronically, and prepares case files for review and/or further routing.