Appeals Specialist – CGS Admin
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Job Description
Appeals Specialist performing non-medical reviews and processing redetermination letters for BlueCross BlueShield of South Carolina. Collaborating with teams to ensure accuracy and timeliness in documentation.
Responsibilities:
- Performs non-medical reviews and processes redetermination letters ensuring timeliness and accuracy.
- Prepares unit reports, analyzes and interprets workload, and processes issues utilizing various software tools.
- Updates letter's and documents within the department when necessary.
- May gather and prepare documentation for legal inquiries and administrative requests.
Requirements:
- High School Diploma or equivalent
- 2 years job related field
- Demonstrated proficiency in word processing and spreadsheet software
- Excellent organizational, customer service, and written and verbal communication skills
- Good judgment skills.
- Proficiency in spelling, punctuation, and grammar skills.
- Microsoft Office proficiency
Benefits:
- Subsidized health plans, dental and vision coverage
- 401k retirement savings plan with company match
- Life Insurance
- Paid Time Off (PTO)
- On-site cafeterias and fitness centers in major locations
- Education Assistance
- Service Recognition
- National discounts to movies, theaters, zoos, theme parks and more
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