Specialist, Appeals - Hybrid, Nashville, TN or Columbia, SC Only

Posted:
9/11/2024, 4:03:58 AM

Location(s):
Tennessee, United States ⋅ Nashville-Davidson, Tennessee, United States

Experience Level(s):
Junior ⋅ Mid Level

Field(s):
Customer Success & Support

Workplace Type:
On-site


Summary
 

Performs non-medical reviews and processes redetermination letters.

Hybrid-3 days onsite with 2 days at home. Provided with laptop, monitor and accessories as well as a designated seat in the office.

Flexible work hours can start as early as 5am central standard time, latest start time 9am. This is an 8-hour shift.


Description
 

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 letters and documents within the department when necessary.

May gather and prepare documentation for legal inquiries and administrative requests.

Required Education: High School Diploma or equivalent

Required Work Experience: 2 years job related field.

Required Skills and Abilities: 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.

Required Software and Tools: Microsoft Office.

Work Environment: Typical office environment.



 

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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 minorities, females, disabled individuals and 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 physical and mental disabilities.

If you need special assistance or an accommodation while seeking employment, please e-mail [email protected] or call 1-800-288-2227, 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.