Summary
Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, 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, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!
Description
Position Purpose: An Appeals Specialist performs non-medical reviews and processes redetermination letters.
Logistics: Palmetto GBA - one of BlueCross BlueShield's South Carolina subsidiary companies.
Government Clearance: This position requires CMS Security Clearance as it falls within a division subject to Centers for Medicare and Medicaid Services residency requirements.
SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). Under the McNamara-O'Hara Service Contract Act (SCA), employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date.
Location: Onsite at 200 Dozier Blvd, Florence, SC 29501 OR 17 Technology Circle, Columbia, SC 29203.
Working Hours: 8:00 AM – 4:30 PM (flexible after training).
Sponsorship: This position is not eligible for sponsorship now or in the future.
What You’ll 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'll Need The Following:
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.
We Prefer That You Have the Following:
Preferred Work Experience: Medicare Part B.
Our Comprehensive Benefits Package Includes The Following:
We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.
Subsidized health plans, dental and vision coverage
401k retirement savings plan with company match
Life Insurance
Paid Time Off (PTO)
On-site cafeterias and fitness centers in major locations
Education Assistance
Service Recognition
National discounts to movies, theaters, zoos, theme parks and more
What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
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 our recruiter to verify resume specifics and salary requirements.
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.
Skills Required
- High School Diploma or equivalent
- 2 years job related field experience
- Demonstrated proficiency in word processing and spreadsheet software
- Proficiency with Microsoft Office
- Excellent organizational, customer service, and written and verbal communication skills
- Good judgment skills
- Proficiency in spelling, punctuation, and grammar
- CMS Security Clearance
- Medicare Part B experience
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
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!
