Under general supervision, analyzes proposed policies, procedures, forms, and reports. Recommends operational improvement through standardization, simplification, discontinuance and other methods. Recommends installations of new systems/pro...
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. 60%...
Receives and processes outgoing mail. Hand matches explanation of benefits (EOB), remittances, checks, billings, letters, and related inserts in accordance with mail timeliness requirements for each contract. Maintains production data to en...
Conducts business process analyses, needs assessments and preliminary cost/benefit analyses in an effort to align operations solutions with business initiatives. Prepares functional, system and program specifications. Provides management su...
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...
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. 70% Examines and processes comple...
Assists with health management activities/programs for Client Client of South Carolina (BCBSSC) and/or Blue Choice members. 50% Provides health coaching or intervention telephonically or in person for assigned health programs. Utilizes all...
Minimum Required Work Experience: 2 years-instructional design, electronic media design, or related work experience. Partial Onsite - At least 2 days onsite a week and as needed Day to Day: Uses advanced technologies to design/develo...
Department/Unit: Nursing Job Location: City, state Zip-code :Columbia, SC 29203 Job Type (Contract/Perm): Contract Contract Duration: 13 On Call requirement (Yes/No): NO Weekend needed: Not Listed Floating requirement (Yes/No): yes G...
Creates and analyzes reports to support operations. Ensures correctness of analysis, and reports findings in a concise manner to senior management. Directly responsible for accuracy of data as financial and operational decisions are made ba...
Provides prompt, accurate, thorough and courteous responses to all customer inquiries. Performs research as needed to resolve inquiries. Ensures effective customer relations by responding accurately, timely and courteously to telephone, w...
Responsible for responding to routine inquiries. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, de...
Depending on department needs, this job includes the following: cashier, prep cook, food server, dishwasher/pot washer, catering delivery, restocking as needed, and any other need as asked by management. 50% Prepares food. Performs variety...