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Appeals Analyst
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
Senior Provider Relations Representative - IRF RCD
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
Senior Database Report Writer/Analyst
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
Senior Provider Education Consultant - IRF RCD
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
Medical Reviewer I - Remote after 6 months
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
RN Medical Reviewer II
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
Appeals Coordinator
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
Medical Reviewer II - Palmetto GBA
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
Accountant I
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
Manager, Enrollment
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
Medicare Cost Reporting Auditor II
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
Specialist, Contract Compliance II
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
Physical Medicine and Rehabilitation Medical Director
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
Physical Medicine and Rehabilitation Medical Director
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
Contract Administration Manager
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
Medicare Cost Reporting Auditor III
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
Auditor II (DME Accreditation)
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
Molecular Diagnostics Medicare Medical Director - Palmetto GBA
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