Appeals Specialist – CGS Admin

BlueCross BlueShield of South Carolina

Appeals Specialist role at BlueCross BlueShield of South Carolina, processing non-medical reviews and redetermination letters. Opportunity to join a dynamic team with a community focus.

Posted 6/30/2026full-timeNashville • Tennessee • 🇺🇸 United StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates proficiency in non-medical reviews, documentation preparation, and analysis of workload while ensuring accuracy and timeliness. Strong skills in word processing, spreadsheet software, and customer service are essential for effective communication and documentation management.

Highest-signal resume keywords

Medical Claims ProcessingIntermediate-Level Excel SkillsWord Processing ProficiencyCustomer Service SkillsWritten And Verbal Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Documentation PreparationData AnalysisAccuracy In Letter CreationSpelling ProficiencyPunctuation ProficiencyGrammar Proficiency

Soft Skills

Organizational SkillsGood Judgment Skills

Tools & Technologies

Spreadsheet SoftwareWord Processing Software

Industry Keywords

Medicare Part B ExperienceAppeals ProcessingLegal Inquiries Documentation

About the role

Key responsibilities & impact

Performs non-medical reviews and processes redetermination letters ensuring timeliness and accuracy
Prepares unit reports, analyzes and interprets workload, and processes issues utilizing various software tools
Updates letter's and documents within the department when necessary
May gather and prepare documentation for legal inquiries and administrative requests

Requirements

What you’ll need

High School Diploma or equivalent
2 years job related field
Demonstrated proficiency in word processing and spreadsheet software
Excellent organizational, customer service, and written and verbal communication skills
Good judgment skills
Proficiency in spelling, punctuation, and grammar skills
Experience in medical claims processing, appeals, or coding strongly preferred
Medicare Part B experience preferred
Strong computer proficiency
Intermediate-level Excel skills
Experience creating letters and documents by reviewing appeals and extracting information with a high degree of accuracy; updates departmental documents as needed

Benefits

Comp & perks

Subsidized health plans
Dental and vision coverage
401k retirement savings plan with company match
Life Insurance
Paid Time Off (PTO)
On-site cafeterias and fitness centers in major locations
Education Assistance
Service Recognition
National discounts to movies, theaters, zoos, theme parks and more