Non-Medical Appeals Reviewer Job at BlueCross BlueShield of South Carolina, Nashville, TN

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  • BlueCross BlueShield of South Carolina
  • Nashville, TN

Job Description

Join Our Appeals Team!

Be a part of our dynamic appeals team, where you will manage non-medical reviews and process important redetermination letters with attention to detail and accuracy.

Location: This position is onsite in Nashville, TN, full time (40 hours/week) Monday-Friday starting between 6am and 9am to best fit your schedule.

About the Role:

  • Conduct non-medical reviews and ensure timely and accurate processing of redetermination letters.
  • Generate unit reports, analyze workloads, and identify issues utilizing various software applications.
  • Update letters and documentation within the department as needed.
  • Assist in compiling documentation for legal inquiries and administrative requests.

Qualifications:

  • Required Education: High school diploma or equivalent
  • Required Work Experience: 2 years in a related field
  • Required Skills and Abilities: Proficiency in word processing and spreadsheet software, excellent organizational skills, strong customer service orientation, exceptional written and verbal communication skills, and attention to detail in spelling, punctuation, and grammar. Microsoft Office skills are essential.

Preferred Qualifications:

  • Advanced computer skills with the ability to manage multiple software platforms simultaneously.
  • Intermediate proficiency in Excel.
  • Experience in medical claims processing, appeals, billing, or coding.

Employee Benefits:

  • 401(k) retirement savings plan with company match.
  • Subsidized health plans with free vision coverage.
  • Life insurance.
  • Generous paid annual leave that increases with tenure.
  • Nine paid holidays each year.
  • Access to onsite cafeterias and fitness centers in major locations.
  • Wellness programs and discounts for healthy lifestyles.
  • Tuition assistance for continuing education.
  • Recognition for years of service.
  • Incentive and merit plans.
  • Funding for additional certifications and renewal courses.

What to Expect:

After submitting your application, our recruitment team will review your resume to ensure you meet the qualifications. This could include a brief phone interview or email communication to clarify resume details and salary expectations. Management will conduct interviews with qualified candidates, prioritizing those who meet preferred qualifications.

Equal Employment Opportunity:

We are committed to promoting diversity and uphold a policy of nondiscrimination in employment in compliance with applicable laws. We provide equal opportunities for all individuals, including those with disabilities, protected veterans, and individuals with diverse backgrounds. Our commitment includes providing reasonable accommodations as needed during the hiring process.

Job Tags

Full time, Work experience placement, Work at office, Monday to Friday,

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