BlueCross BlueShield of South Carolina

Premium Coordinator

BlueCross BlueShield of South Carolina · Full Time · 2 days ago

BlueCross BlueShield of South Carolina

🌎 United States 💵 $22.26 - $40.74 per hour ⭐ 2-5 yrs exp 💼 Others

The Premium Coordinator manages stop-loss premium activity, including application processing and payment reconciliation. They serve as the primary coordination point for premium inquiries between TPAs, producers, and internal underwriting teams.

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RN Case Management Coordinator

BlueCross BlueShield of South Carolina · Full Time · 3 days ago

BlueCross BlueShield of South Carolina

🌎 United States ⭐ 5-10 yrs exp 💼 Healthcare

The coordinator provides active care management by assessing service needs, developing action plans, and monitoring outcomes to improve client safety and quality of life. They perform medical and behavioral reviews to ensure coverage within benefit guidelines and provide telephonic support for members with chronic or high-risk conditions.

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Senior Underwriter - Stop Loss Focus

BlueCross BlueShield of South Carolina · Full Time · 4 days ago

BlueCross BlueShield of South Carolina

🌎 United States 💵 $57636 - $109K per year ⭐ 5-10 yrs exp 💼 Finance

Rates and designs benefits for large and complex groups while serving as the primary contact for stop loss vendors. Responsibilities include determining risk acceptability, generating proposals, and training less experienced underwriters.

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RN Concierge Care Manager

BlueCross BlueShield of South Carolina · Full Time · 6 days ago

BlueCross BlueShield of South Carolina

🌎 United States ⭐ 5-10 yrs exp 💼 Healthcare

Provide high-touch concierge care management for members with complex conditions such as high-risk maternity, cancer, and behavioral health. Coordinate clinical services with external providers and develop individualized care plans to improve quality of life and cost-effectiveness.

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Medicare Cost Report Auditor III

BlueCross BlueShield of South Carolina · Full Time · 6 days ago

BlueCross BlueShield of South Carolina

🌎 United States 💵 $57790 - $110K per year ⭐ 5-10 yrs exp 💼 Finance

Conduct comprehensive financial, compliance, and operational audits to evaluate internal controls and identify business risks. Prepare detailed audit reports and recommendations for executive management to improve corporate processes and ensure regulatory compliance.

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RN Case Management Coordinator - NICU/Maternity (W@H Anywhere)

BlueCross BlueShield of South Carolina · Full Time · 6 days ago

BlueCross BlueShield of South Carolina

🌎 United States 💵 $45724 - $87781 per year ⭐ 2-5 yrs exp 💼 Healthcare

The RN Case Management Coordinator provides active care management, assesses service needs, and coordinates action plans to improve health outcomes and reduce care fragmentation. Responsibilities include performing medical reviews, providing telephonic support for high-risk members, and advocating for members within the healthcare delivery system.

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Marketing Project Specialist - Remote from Columbia, SC

BlueCross BlueShield of South Carolina · Full Time · 8 days ago

BlueCross BlueShield of South Carolina

🌎 United States ⭐ 2-5 yrs exp 💼 Product

Conducts primary and secondary market research to develop new products and strategic marketing plans. Manages the implementation and post-launch performance of major marketing projects and promotional campaigns.

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Senior Data Preparation Technician

BlueCross BlueShield of South Carolina · Full Time · 8 days ago

BlueCross BlueShield of South Carolina

🌎 United States ⭐ 5-10 yrs exp 💼 Others

Performs advanced clerical duties including scanning, indexing, and quality control of documentation and records. Coordinates departmental activities, maintains logs, and prepares basic production reports for management.

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RN Appeals Analyst Medicare Part B - CGS

BlueCross BlueShield of South Carolina · Full Time · 11 days ago

BlueCross BlueShield of South Carolina

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

Research and analyze complex appeal or retrospective review requests to determine if services meet medical necessity guidelines. Document decisions accurately and timely in compliance with applicable regulations and standards.

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Chief Medical Officer (Medicare Policy)

BlueCross BlueShield of South Carolina · Full Time · 14 days ago

BlueCross BlueShield of South Carolina

🌎 United States ⭐ 5-10 yrs exp 💼 Healthcare

Provides administrative oversight to medical staff and leads the generation and revision of medical policies. Analyzes utilization data and conducts research on new medical procedures to guide operational policies and claim adjudication.

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Auditor III

BlueCross BlueShield of South Carolina · Full Time · a month ago

BlueCross BlueShield of South Carolina

🌎 United States ⭐ 5-10 yrs exp 💼 Finance

The role involves conducting a full range of financial, compliance, and operational audits to evaluate internal controls and identify business risks. The Auditor III also drafts recommendations for executive management to improve processes and prevent fraud.

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Accounting Technician III

BlueCross BlueShield of South Carolina · Full Time · 8 months ago

BlueCross BlueShield of South Carolina

🌎 United States ⭐ 2-5 yrs exp 💼 Finance

Under general supervision, the Accounting Technician III performs a variety of routine to complex clerical and accounting functions. Responsibilities include inventory balancing, reconciliations, processing disbursements and deposits, and generating refund request letters.

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