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Appeals Specialist - Non-Medical Reviews & Docs

Southcarolinablues

BlueCross BlueShield of South Carolina’s CGS Administrators is seeking detail-oriented professionals to join our team in Nashville. This onsite/remote role supports non-medical claims reviews, redetermination letters, and department document updates as part of Medicaid-related operations. You'll analyze workload, prepare unit reports, and collaborate across systems using Microsoft Office. Required: high school diploma, 2 years related experience, strong writing and communication skills, and #J-18808-Ljbffr Southcarolinablues

Vacancy posted 1 day ago
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