Appeals Specialist (CGS Admin)

Appeals Specialist – BlueCross BlueShield of South Carolina BlueCross BlueShield of South Carolina (BCBSSC) is hiring an Appeals Specialist to perform non‑medical reviews and process redetermination letters. Location & Schedule Position may be onsite or remote. Onsite location: 26 Century Blvd, Suite ST610, Nashville, TN 37214. Work hours start between 6:00AM and 7:30AM Central Time with an 8‑hour shift and possible occasional overtime. Key Responsibilities Perform non‑medical reviews and process redetermination letters ensuring timeliness and accuracy. Prepare unit reports, analyze and interpret workload, and address issues using various software tools. Update letters and documents within the department when necessary. Gather and prepare documentation for legal inquiries and administrative requests. Required Qualifications High School Diploma or equivalent. Minimum 2 years of relevant work experience. Proficiency in word processing and spreadsheet software. Excellent organizational, customer service, written and verbal communication skills. Good judgment and strong spelling, punctuation, and grammar skills. Proficiency with Microsoft Office. Preferred Qualifications Experience in medical claims processing, appeals, or coding. Medicare Part B experience. Strong computer proficiency, multiple system navigation, dual‑screen work. Intermediate Excel skills. Experience creating letters and documents by reviewing appeals with high accuracy and updating departmental documents. Benefits & Compensation BCBSSC offers health, dental, and vision coverage, a 401(k) with company match, life insurance, paid time off, on‑site cafeterias and fitness centers, education assistance, service recognition, and national discounts to movies, theaters, zoos, theme parks, etc. Benefits begin the first of the month following 28 days of employment. Equal Employment Opportunity Statement BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy‑related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email View email address on click.appcast.io or call View phone number on click.appcast.io with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case‑by‑case basis. We participate in E‑Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. #J-18808-Ljbffr