Appeals Coordinator

Coordinator, Appeals

Palmetto GBA is seeking a detail-oriented and organized Coordinator, Appeals to join our appeals processing team. In this role, you will serve as the frontline support for all incoming appeal requests reviewing, triaging, and routing cases to ensure timely and accurate processing in accordance with CMS guidelines. If you thrive in a structured, fast-paced environment and take pride in accuracy and organization, we'd love to hear from you!

What You Will Do:

• Research requests, enter appropriate data to identify case specifics, and build appeals cases in the system.
• Log requests to the appropriate functional area, generate letters, assemble files, order records, and obtain additional information as directed.
• Ensure quality control of all appeals on the appeals system, pend documents to be saved electronically, and prepare case files for review and/or further routing.

To Qualify for This Position, You Will Need:

• High School Diploma or equivalent
• 1 year of administrative support/clerical or job-related experience
• Demonstrated proficiency in word processing and spreadsheet software
• Effective organizational and customer service skills
• Good judgment skills
• Proficiency in spelling, punctuation, and grammar
• Demonstrated written and verbal communication skills
• Microsoft Office proficiency

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.

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