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BlueCross BlueShield of South Carolina
- Columbia, SC / Atlanta, GA / Burlington, VT / 48 more...
Researches and resolves escalated, complex, and high profile claims issues. Serves as POC (point of contact) with various professional and facility/hospital providers in the research and resolution of all claims issues. May assist with escalated issues to include, but not limited to provider enrollment, medical review, appeals and/or finance. Completes research efficientl
Posted Today
BlueCross BlueShield of South Carolina
- Columbia, SC / Atlanta, GA / Burlington, VT / 48 more...
Functions as the team lead and subject matter expert for a claims area. Responsible for creating reports, distributing workload and training new employees. Description Responds accurately and timely to inquiries from team members, including management, concerning claims processing and other technical issues. Investigates and initiates resolutions to complex claims problem
Posted Today
BlueCross BlueShield of South Carolina
- Columbia, SC / Atlanta, GA / Burlington, VT / 48 more...
Functions as the team lead and subject matter expert for a claims area. Responsible for creating reports, distributing workload and training new employees. Description Responds accurately and timely to inquiries from team members, including management, concerning claims processing and other technical issues. Investigates and initiates resolutions to complex claims problem
Posted 4 days ago
BlueCross BlueShield of South Carolina
- Roseville, MN / Atlanta, GA / Burlington, VT / 47 more...
Directs and coordinates all components for the development of new business to include working across various functional areas (underwriting, marketing, claims, information systems, operations, etc.). Evaluates marketing strategies/plans to meet ever changing market and competitive conditions. Develops and recommends sales strategies, marketing plans, and related changes n
Posted 6 days ago
BlueCross BlueShield of South Carolina
- Charleston, SC / Atlanta, GA / Burlington, VT / 46 more...
Provides key financial reports/analysis to support senior management in planning/evaluation requirements/meeting financial objectives related to strategic Pharmacy Benefit Management (PBM) services. Performs analysis, validation and oversight of Corporate PBM Agreement and self funded employer PBM Addenda. Conducts complex market research/competitive analysis/valuation/fi
Posted 7 days ago
Contributes as a part of a team to the design and usability of internal and external browser based applications throughout the scope, development, and implementation process. Transforms concepts and requirements into usable interfaces that are aligned with business goals, user goals, and system constraints while applying best practices. Description Who are we? DocFinity,
Posted 7 days ago
Contributes as a part of a team to the design and usability of internal and external browser based applications throughout the scope, development, and implementation process. Transforms concepts and requirements into usable interfaces that are aligned with business goals, user goals, and system constraints while applying best practices. Ensure quality, leverage automated
Posted 7 days ago
BlueCross BlueShield of South Carolina
- Charleston, SC / Atlanta, GA / Burlington, VT / 47 more...
Involved in all aspects of the Molecular Diagnostic Program (MoIDX) laboratory operations and serves as an internal subject matter expert, applying medical knowledge to advise decisionmakers in support of MoIDX's mission. Responsible for review and approval of documentation and reports, supporting clinical testing strategies, as well as new assay development and validatio
Posted 7 days ago
BlueCross BlueShield of South Carolina
- Birmingham, AL / Atlanta, GA / Burlington, VT / 46 more...
Responsible for completing cost report reopenings within established timeframes and ensuring that the quality of our work meets CMS expectations. Reopenings include review of various provider types and issues related to the Medicare cost report. Description Conducts internal and external timely operational, compliance, and financial audits of divisions, departments, provi
Posted 7 days ago
BlueCross BlueShield of South Carolina
- Columbia, SC / Atlanta, GA / Burlington, VT / 48 more...
Responsible for providing a full range of financial, compliance, and operational audits, business advisory, and consultation services, investigations, internal controls, accountability, and use of resources. Description Conducts internal and/or external timely operational, financial, and/or compliance audits of divisions, departments, providers, and activities of the corp
Posted 19 days ago
BlueCross BlueShield of South Carolina
- Columbia, SC / Atlanta, GA / Burlington, VT / 48 more...
Responsible for providing a full range of financial, compliance, and operational audits, business advisory, and consultation services, investigations, internal controls, accountability, and use of resources. Description Conducts internal and/or external timely operational, financial, and/or compliance audits of divisions, departments, providers, and activities of the corp
Posted 19 days ago
BlueCross BlueShield of South Carolina
- Springfield, IL / Atlanta, GA / Burlington, VT / 47 more...
Responsible for providing a full range of financial, compliance, and operational audits, business advisory, and consultation services, investigations, internal controls, accountability, and use of resources. Description This position is remote. 50% Conducts internal and/or external timely operational, financial, and/or compliance audits of divisions, departments, provider
Posted 21 days ago
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