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Responsible for supporting the business development and maintenance of a department's website. Analyzes web business needs and the subsequent development of strategies to meet those needs. Description Supports internet/intranet development and content for the division/department. Assesses web business needs/problems and identifies revenue generating opportunities using we
Posted Today
Performs non medical reviews and processes redetermination letters. Description 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 an
Posted Today
Provides leadership to a team of expert technology design architects in the overall design of Infrastructure Management Process Architectures under the direction of the Chief Technology Officer (CTO). Responsible for leading the design of infrastructure architecture standards, tools, best practices, and related development methodologies. Develop strategies and direction f
Posted 1 day ago
Provides a wide variety of administrative and staff support services. Coordinates more complex and diverse area specific projects. Administers programs, projects and processes requiring area specific knowledge. Operates a desktop computer and is proficient in working with assorted software, tools and systems utilized in the area. Description Position will be on site in Na
Posted 1 day ago
Provides prompt, accurate, thorough and courteous responses to all customer inquiries. Inquiries may be non routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Description 60% Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, or walk
Posted 2 days ago
Reviews and adjudicates complex or specialty claims. Determines whether to return, deny or pay claims following organizational policies and procedures. Assists in training or mentoring new staff members. Description 70% Examines and processes complex or specialty claims according to business/contract regulations, internal standards and examining guidelines. Enters claims
Posted 2 days ago
Responsible for responding to customer inquiries. Inquiries may be non routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or non medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures. Description 45% E
Posted 2 days ago
The incumbent is expected to successfully complete the course curriculum for BlueCross' IT Entry Level Training Program (ELTP). Our non host systems training is designed to prepare entry level computer programmers for a career in our application development areas that are not mainframe based. This includes the areas responsible for the development and maintenance of corpo
Posted 2 days ago
Provides prompt, accurate, thorough and courteous responses to all customer inquiries. Performs research as needed to resolve inquiries. Description 65% Ensures effective customer relations by responding accurately, timely and courteously to telephone, written, web, or walk in inquiries. Accurately documents inquiries. 15% Initiates or processes adjustments or performs ot
Posted 2 days ago
Performs routine, but varied clerical duties in accordance with standard procedures. This includes clerical duties such as photocopying, compiling records, filing, tabulating, posting information, and distributing mail. Applies knowledge of department policies and procedures, and utilizes a general understanding of other departments' functions. Maintains records, prepares
Posted 4 days ago
BlueCross BlueShield of South Carolina
- Charleston, SC / Atlanta, GA / Burlington, VT / 33 more...
As member of the senior management team, provides administrative oversight to the medical staff, analyzes medical review utilization data, researches new medical procedures or technology, and acts as a resource to providers and internal staff on issues concerning medical policies. May also write and revise medical policies. Description Supports operations in the form of c
Posted 4 days ago
BlueCross BlueShield of South Carolina
- Washington, DC / Wilmington, DE / Blue Bell, PA / 8 more...
Companion Data Services (CDS) is a part of the Celerian Group, a consortium of companies which act as subsidiaries to BlueCross BlueShield of South Carolina. CDS provides leading IT solutions and managed services. We operate multiple geographically disperse data centers, including two of the nation's largest healthcare data centers both rated among the top five percent of
Posted 4 days ago
Provides daily professional administrative, clerical, and project coordination support. Maintains area files, correspondence, reports, and other documentation. Coordinates, completes, and delivers required reporting. Tasks are varied and usually require area specific knowledge to complete work. Description Types, edits, formats, reviews, and updates forms, correspondence,
Posted 4 days ago
Care management interventions focus on improving care coordination and reducing the fragmentation of the services the recipients of care often experience, especially when multiple health care providers and different care settings are involved. Taken collectively, case management interventions are intended to enhance client safety, well being, and quality of life. These in
Posted 4 days ago
Responsible for the accurate and timely processing of claims. Description In office position in Nashville, TN. Researches and processes claims according to business regulation, internal standards and processing guidelines. Verifies the coding of procedure and diagnosis codes. Resolves system edits, audits and claims errors through research and use of approved references a
Posted 4 days ago
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