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Responsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Description 60% Researches and responds to telephone inquiries according to desk procedures, ensuring that contract standards and objectives for timeliness, productivity, and quality are m
Posted 1 day ago
BlueCross BlueShield of South Carolina
- Charleston, SC / Aiken, SC / Columbia, SC / 7 more...
Responsible for the successful marketing (sales, renewals, and/or service) of group and/or individual accounts for products as defined by production quotas within assigned territory. Customarily and regularly engaged in outside sales. This is a work from home role that must reside in one of the following counties Aiken, Barnwell, Allendale, Bamberg, Orangeburg, Richland, Lexington, Calhoun, OR Cla
Posted 1 day ago
Responsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Description Researches and responds to telephone inquiries according to desk procedures, ensuring that contract standards and objectives for timeliness, productivity, and quality are met.
Posted 1 day ago
Responsible for daily workflow activities to include the following membership/enrollment activities processing of applications for new enrollments, terminations/cancellations, changes, renewals, database updates, and/or monthly billings. This role is located in Phoenix, Arizona. Description 50% Receives and logs subscriber and member enrollment applications to the system. Processes/keys complex
Posted 1 day ago
Performs non medical reviews and processes redetermination letters. Description 50% Performs non medical reviews and processes redetermination letters ensuring timeliness and accuracy. 30% Prepares unit reports, analyzes and interprets workload, and processes issues utilizing various software tools. 10% Updates letters and documents within the department when necessary. 10% May gather and prepar
Posted 1 day ago
Intern position utilized for training an active college student towards a professional level role. Responsibilities vary and are based upon the needs of the area and the experience of the incumbent at the time of employment. This incumbent works under direct supervision and has responsibilities for performing entry level tasks and for learning professional level tasks relating to area operations.
Posted 1 day ago
Intern position utilized for training an active college student towards a professional level role. Responsibilities vary and are based upon the needs of the area and the experience of the incumbent at the time of employment. This incumbent works under direct supervision and has responsibilities for performing entry level tasks and for learning professional level tasks relating to area operations.
Posted 1 day ago
Intern position utilized for training an active college student towards a professional level role. Responsibilities vary and are based upon the needs of the area and the experience of the incumbent at the time of employment. This incumbent works under direct supervision and has responsibilities for performing entry level tasks and for learning professional level tasks relating to area operations.
Posted 1 day ago
Intern position utilized for training an active college student towards a professional level role. Responsibilities vary and are based upon the needs of the area and the experience of the incumbent at the time of employment. This incumbent works under direct supervision and has responsibilities for performing entry level tasks and for learning professional level tasks relating to area operations.
Posted 1 day ago
Intern position utilized for training an active college student towards a professional level role. Responsibilities vary and are based upon the needs of the area and the experience of the incumbent at the time of employment. This incumbent works under direct supervision and has responsibilities for performing entry level tasks and for learning professional level tasks relating to area operations.
Posted 1 day ago
Responsible for submitting stop loss claim packets and responding to any requests for additional information. Additionally, the claims must be tracked and monitored. Complex analysis is performed and queries are generated to file and validate the claim submissions. Description 25% Prepare and file 50% and 100% stop loss claim packets. Run queries, compile eligibility data and submit claim packet
Posted 1 day ago
Responsible for the maintenance of records and the processing of claims in medical review along with any and/or all of the following processes ingoing/outgoing mail and prepares work for nursing staff. Troubleshoots claims prior to nurse review and after review. Monitors timeliness of claims processing and adjusts claims keyed incorrectly. Performs quality control of work processes. Description
Posted 1 day ago
Provides prompt, accurate, thorough and courteous responses to all telephone inquiries. Performs research as needed to resolve inquiries. Description 65% Ensures effective customer relations by responding accurately, timely and courteously to telephone inquiries. Accurately documents inquiries. 15% Initiates minor /clerical adjustments based on provider request or processes adjustments or perfor
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 other research as needed t
Posted 2 days ago
To strategically and tactically manage the underwriting staff as well as maximize premium production while minimizing financial risk, and underwriting of new/renewal contracts. Decisions made in this position have the opportunity to produce income and/or prevent loss. Description 30% Responsible for recruiting and hiring, coaching and mentoring, monitoring and evaluation, and addressing all disc
Posted 2 days ago
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