Coordinator, Appeals

Palmetto GBA•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. Equal Employment Opportunity Statement 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. Some states have required notifications. Here's more information. If you don’t have an account with us and don’t see the dream job you are looking for, click on the link above to Join Our Talent Community by submitting your resume and contact information and we will reach out if we find a good fit. Palmetto GBA is a healthcare service administrator and one of the nation’s largest providers of high-volume medical claims and transaction processing. We provide services and technology solutions to improve and streamline healthcare administration not only for government but also for corporate entities. We offer a wide range of services that require a diverse workforce and expansive areas of expertise from data analytics, administrative and workflow services to advanced systems. To help our associates succeed and reach their professional goal, we offer training classes and programs that help employees prepare for leadership positions and offer tuition assistance for education advancement. Palmetto GBA acknowledges associates’ hard work and dedication with awards and financial incentives.

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.