About the Role
Summary Responsible for maintaining the proper flow of the request for appeals. Description Logistics: Palmetto GBA - a BlueCross BlueShield of South Carolina subsidiary company. Please submit your application along with an updated resume for consideration. This position requires CMS Security Clearance as it falls within a division subject to Centers for Medicare and Medicaid Services residency requirements. Compensation Grade 130 — candidates currently in a lower grade are encouraged to apply as this may represent a promotional opportunity. Onsite — Government Programs Complex (GPC), 17 Technology Circle, Columbia, SC Work Type: Full-Time | Onsite Compensation Grade: 130 Hours: 8:30 AM – 5:00 PM About This Opportunity Palmetto GBA is seeking a detail-oriented and organized Coordinator, Appeals to join our appeals processing team. In this role, you will serve as the frontline support for all incoming appeal requests — reviewing, triaging, and routing cases to ensure timely and accurate processing in accordance with CMS guidelines. If you thrive in a structured, fast-paced environment and take pride in accuracy and organization, we'd love to hear from you! What You Will Do: Research requests, enter appropriate data to identify case specifics, and build appeals cases in the system. Log requests to the appropriate functional area, generate letters, assemble files, order records, and obtain additional information as directed. Ensure quality control of all appeals on the appeals system, pend documents to be saved electronically, and prepare case files for review and/or further routing. To Qualify for This Position, You Will Need: High School Diploma or equivalent 1 year of administrative support/clerical or job-related experience Demonstrated proficiency in word processing and spreadsheet software Effective organizational and customer service skills Good judgment skills Proficiency in spelling, punctuation, and grammar Demonstrated written and verbal communication skills Microsoft Office proficiency What We Prefer: 3 years of experience in claims, customer service, or healthcare program management Ability to persuade, negotiate, or influence Knowledge of Microsoft Access or other database software 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. Welcome Here’s Your Smart Career Move Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. Business and political climates may change, but we’re stronger than ever. Our A.M. Best rating is A+ (Superior) — making us the only health insurance company in South Carolina with that rating. We’re the largest insurance company in South Carolina … and much more. We are one of the nation’s leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Veterans Welcome! BlueCross is a strong supporter of our veterans, and many service men and women have joined our ranks. We’ve found the dedication, work ethic and job skills that serve well in the military excel in many of our lines of business, and we proudly have veterans filling positions in Human Resources, Information Technology, Customer Service, Operations, General Services and more. Through our government contracts, we also have employees serving at Shaw Air Force Base, the Naval Health Clinic in Charleston, the Naval Hospital in Beaufort and in our hometown of Columbia, S.C., at Ft. Jackson. If you are a full-time employee in the National Guard or Reserves, we will even cover the difference in your pay if you are called to active duty. Join Us If you're ready to join in a diverse company with secure, community roots and an innovative future, apply for a position now!