Summary
We are currently hiring for an Appeals Specialist to join BlueCross BlueShield of South Carolina. In this role as Appeals Specialist, you will be required to perform non-medical reviews and process redetermination letters.
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 have been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are 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 committed to the same philosophy, consider joining our team!
Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.
Description
Location
This position is onsite, full time (40 hours/week) Monday-Friday 8am-5pm in our Nashville, TN location.
What You Will Do:
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
To Qualify for This Position, You Will Need:
Required Education: High school diploma or equivalent
Required work experience: 2 years in a job-related field
Required Skills and abilities: Demonstrated proficiency in word processing and spreadsheet software, excellent organizational, customer-service, and written and oral communications skills, good judgment, proficiency in spelling, punctuation and grammar, Microsoft Office skills
We Prefer That You Have The Following:
Critical thinking skills to be able to research and apply Medicare Rules and Regulations to the appeal request.
Excellent computer skills with the ability to navigate between multiple software platforms and work on multiple computer screens.
Intermediate Excel skills.
Medical claims processing, appeals, billing, or coding experience.
What We Can Do for You:
401(k) retirement savings plan with company match.
Subsidized health plans and free vision coverage.
Life insurance.
Paid annual leave – the longer you work here, the more you earn.
Nine paid holidays.
On-site cafeterias and fitness centers in major locations.
Wellness programs and healthy lifestyle premium discount.
Tuition assistance.
Service recognition.
Incentive Plan.
Merit Plan.
Continuing education funds for additional certifications and certification renewal.
What to Expect Next:
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and salary requirements.
Management will be conducting interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications.
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 [email protected] 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.
BlueCross BlueShield of South Carolina Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about BlueCross BlueShield of South Carolina and has not been reviewed or approved by BlueCross BlueShield of South Carolina.
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Healthcare Strength — The package includes multiple medical and dental plan options, free vision, company‑paid life insurance, and short‑/long‑term disability, plus wellness programs and an EAP. On‑site clinics and fitness centers at major locations complement core health coverage.
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Leave & Time Off Breadth — Paid time off starts at about four weeks per year alongside nine paid holidays. This provides substantial baseline leave from day one.
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Wellbeing & Lifestyle Benefits — Wellness discounts, coaching, and incentives are emphasized, with on‑site fitness resources where available. Additional tools and services support day‑to‑day wellbeing.
BlueCross BlueShield of South Carolina Insights
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What We Do
For more than six decades, BlueCross BlueShield of South Carolina has been part of the national landscape. Our roots are firmly embedded in the state. We are the largest insurance company in South Carolina. We are also the only one that has an A+ Superior A.M. Best rating. We are one of the nation's leading government contract administrators. We operate one of the most sophisticated data processing centers in the Southeast and have a diverse family of subsidiary companies. Our full-time employees enjoy benefits like a 401(k) retirement savings plan with company match, subsidized health plans, free vision coverage, life insurance, paid annual leave and holidays, wellness programs and education assistance. If you are a full-time employee in the National Guard or reserves, we will cover the difference in your pay if you are called to active duty. BlueCross has a dedicated corporate culture of community support. Our employees are some of the most giving in the country. They support dozens of nonprofit organizations every year. If you're ready to join a diverse company with secure, community roots and an innovative future, apply for a position now!
