PGBA

SummaryPerforms medical reviews using established criteria sets and/or performs utilization management of professional inpatient or outpatient facility benefits or services and appeals. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and re

SummaryPerforms medical reviews using established criteria sets and/or performs utilization management of professional inpatient or outpatient facility benefits or services and appeals. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and re

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companiesLocation: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. It may be nec

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companiesLocation: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. It may be nec

SummaryReviews and adjudicates complex or specialty claims. Determines whether to return deny or pay claims following organizational policies and procedures. Assists in training or mentoring new staff members.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina sub

SummaryReviews and adjudicates complex or specialty claims. Determines whether to return deny or pay claims following organizational policies and procedures. Assists in training or mentoring new staff members.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina sub

SummaryResponsible for identifying training needs developing training materials and facilitating training. Provides training guidance and leadership for new training specialists. Develops performance assessments and testing materials. Manages trainees and communicates effectively with

SummaryResponsible for identifying training needs developing training materials and facilitating training. Provides training guidance and leadership for new training specialists. Develops performance assessments and testing materials. Manages trainees and communicates effectively with

SummaryWe have a job opening for the position of Summer Student Intern at PGBA a subsidiary of BlueCross BlueShield of South Carolina. The Intern position is utilized for training an active high school or college student towards an entry level role. The responsibilities vary and are

SummaryWe have a job opening for the position of Summer Student Intern at PGBA a subsidiary of BlueCross BlueShield of South Carolina. The Intern position is utilized for training an active high school or college student towards an entry level role. The responsibilities vary and are

SummaryUnder general supervision performs a variety of routine to moderately complex clerical/accounting functions such as inventory balancing reconciliations generating refund request letters processing disbursements and deposits keying journal entries and logging items in accordance

SummaryUnder general supervision performs a variety of routine to moderately complex clerical/accounting functions such as inventory balancing reconciliations generating refund request letters processing disbursements and deposits keying journal entries and logging items in accordance

SummaryPerforms medical reviews using established criteria sets and/or performs utilization management of professional inpatient or outpatient facility benefits or services and appeals. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and re

SummaryPerforms medical reviews using established criteria sets and/or performs utilization management of professional inpatient or outpatient facility benefits or services and appeals. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and re

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companies.Location: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role i

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companies.Location: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role i

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companies.Location: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role i

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companies.Location: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role i

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companiesLocation: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. It may be nec

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companiesLocation: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. It may be nec

SummaryResponsible for providing a full range of financial compliance and operational audits business advisory and consultation services investigations internal controls accountability and use of resources.DescriptionThe Auditor position is a full-time (40 hours) remote position. This

SummaryResponsible for providing a full range of financial compliance and operational audits business advisory and consultation services investigations internal controls accountability and use of resources.DescriptionThe Auditor position is a full-time (40 hours) remote position. This

SummaryWe are currently hiring for a Part-Time Claims Customer Service Advocate II to join BlueCross BlueShield of South this role as a Claims Customer Service Advocate II you will be responsible for helping our customers in a timely prompt and accurate way to answer some of their mo

SummaryWe are currently hiring for a Part-Time Claims Customer Service Advocate II to join BlueCross BlueShield of South this role as a Claims Customer Service Advocate II you will be responsible for helping our customers in a timely prompt and accurate way to answer some of their mo

SummaryResponsible for directing all contract activities to ensure that contractual obligations are met and compliance is maintained with mandatory government regulations applicable laws and Corporate policies/ addition this position is responsible for interacting with contracting par

SummaryResponsible for directing all contract activities to ensure that contractual obligations are met and compliance is maintained with mandatory government regulations applicable laws and Corporate policies/ addition this position is responsible for interacting with contracting par

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companiesLocation: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. It may be nec

SummaryResponsible for the accurate and timely processing of claims.DescriptionLogistics: PGBA one of BlueCross BlueShields South Carolina subsidiary companiesLocation: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. It may be nec

SummaryResponsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions.DescriptionJob DescriptionPosition Purpose:From the moment of login y

SummaryResponsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions.DescriptionJob DescriptionPosition Purpose:From the moment of login y

SummaryResponsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions.DescriptionLogistics - PGBA one of BlueCross BlueShields South Caroli

SummaryResponsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions.DescriptionLogistics - PGBA one of BlueCross BlueShields South Caroli

SummaryResponsible for the accurate and timely processing of claims.DescriptionLocation: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role is located on-site at 8733 Highway 17 Bypass Myrtle Beach SCWhat Youll Do: Research

SummaryResponsible for the accurate and timely processing of claims.DescriptionLocation: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environment. This role is located on-site at 8733 Highway 17 Bypass Myrtle Beach SCWhat Youll Do: Research

SummaryJob Description SummaryWe are currently hiring for a Part-Time Claims Customer Service Advocate II to join BlueCross BlueShield of South this role as a Claims Customer Service Advocate II you will be responsible for helping our customers in a timely prompt and accurate way to

SummaryJob Description SummaryWe are currently hiring for a Part-Time Claims Customer Service Advocate II to join BlueCross BlueShield of South this role as a Claims Customer Service Advocate II you will be responsible for helping our customers in a timely prompt and accurate way to

SummaryWe have a job opening for the position of Business Management Summer Student Intern at PGBA a subsidiary of BlueCross BlueShield of South Carolina. The Intern position is utilized for training an active high school or college student towards an entry level role. The responsibi

SummaryWe have a job opening for the position of Business Management Summer Student Intern at PGBA a subsidiary of BlueCross BlueShield of South Carolina. The Intern position is utilized for training an active high school or college student towards an entry level role. The responsibi

SummaryReviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise administrative policies and established clinical criteria to service requests. Utilizes clinical proficiency and claims knowledge/analysis to assess p

SummaryReviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise administrative policies and established clinical criteria to service requests. Utilizes clinical proficiency and claims knowledge/analysis to assess p