Specialist, Appeals

BlueCross BlueShield of South Carolina

Appeals Specialist performing non-medical reviews and processing redetermination letters at BlueCross BlueShield. Ensuring accuracy and timeliness in compliance with CMS requirements.

Posted 7/10/2026full-timeFlorence • South Carolina • 🇺🇸 United StatesJuniorMid-LevelWebsite

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 letters 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
Microsoft Office proficiency

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

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Word ProcessingSpreadsheet SoftwareDocumentation PreparationData AnalysisReport Preparation

Soft Skills

Organizational SkillsWritten Communication SkillsVerbal Communication SkillsGood Judgment Skills

Certifications

High School Diploma or Equivalent