Jobs at BlueCross BlueShield of South Carolina

Assist in executing financial, compliance, and operational audits, evaluating internal controls, and reporting findings. Analyze financial data and recommend corrective actions.

Perform cost accounting duties including pricing, billings, reconciliations, pool allocations, intercompany reports, variance analysis, budgeting support, audit coordination, financial reporting, and presenting findings to management. Prepare journal entries, maintain general ledger, develop forecasts and rates, review staff work, support system enhancements, and handle special projects. Requires strong Excel, analytical, and communication skills.

Create and maintain healthcare provider files in PIMS/AMMS to support provider directories, claims adjudication, and billing. Verify provider information, assign networks, run maintenance/error reports, and participate in projects like audits and mass updates.

Manage a team to ensure accurate, timely claims processing and adjudication. Develop processing standards and use automated systems, ensure compliance with laws and contracts, monitor reports and audits, provide training, and maintain high customer service while coordinating with internal departments.

Supervise statistical reporting and clinical data analysis to produce reports and trend analyses, develop data-driven solutions, collaborate on requirements and testing, and coach a team of analysts to improve outcomes and reduce expense.

Manage assigned claims operations, ensuring investigations and adjudications meet standards. Develop staff, maintain external relationships, and oversee claims handling.

This role focuses on selling insurance products through telemarketing, managing calls, following up on leads, and preparing marketing materials.

The Premium Coordinator ensures accuracy in payment processing and reconciliations, serving as a liaison between financial teams and partners while adhering to established workflows.

The EDI Operations Associate handles customer calls, processes EDI requests, manages service logs, and assists with audits and data analysis tasks.

Responsible for the accurate processing of claims, resolving errors, and coordinating with departments to maintain patient and provider information.

The Quality Assurance Analyst conducts quality control audits and reviews, analyzes processes, documents findings, and provides feedback for improvements in operations functions.

The Senior Proposal Specialist develops high-quality proposals for strategic RFPs and RFIs, coordinating with sales and SMEs while managing proposal processes and crafting compelling narratives.

The Director, Individual Sales manages individual sales teams to increase sales, retention, and service in health insurance markets, while developing strategies and overseeing account management.

Support the sales team by managing RFPs, client references, and partner relationships; improve sales processes; develop presentations and materials; gather market and competitive intelligence; and coordinate cross-functional execution to ensure timely, high-quality sales outcomes.

The Claims Processor I-4 is responsible for processing claims accurately and on time, handling system edits, and coordinating with internal departments to verify and update patient information.

Responsible for marketing and selling group and individual health insurance products, managing relationships with local chambers, and executing sales strategies in South Carolina.

Audit and authorize medical stop loss claims, mitigate client claims, generate reports, and provide customer support. Requires 6 years of claims experience.

The Client Relationship Manager serves as the day-to-day lead for client issues, manages accounts, and coordinates with internal teams to resolve issues and meet client needs.

Manage underwriting staff, maximize premium production, and minimize financial risk while developing new product strategies and approving large quotes.

The candidate will perform application analysis, design solutions, maintain programs, and analyze existing systems for enhancements, ensuring timely delivery of software.