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Appeals Specialist
BlueCross BlueShield of South Carolina. Perform non-medical reviews and process redetermination letters, ensuring timeliness and accuracy .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates proficiency in Microsoft Office and strong organizational skills while performing non-medical reviews and preparing documentation for legal inquiries. Excellent written and verbal communication abilities are essential for ensuring accuracy and timeliness in processing redetermination letters.
Highest-signal resume keywords
Microsoft Office ProficiencyWord Processing SkillsSpreadsheet Software SkillsOrganizational SkillsCMS Security Clearance
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Word ProcessingSpreadsheet SoftwareDocumentation PreparationData AnalysisTimeliness and Accuracy
Soft Skills
Customer ServiceWritten CommunicationVerbal CommunicationGood JudgmentOrganizational Skills
Certifications & Qualifications
High School Diploma or EquivalentCMS Security Clearance
Industry Keywords
Non-Medical ReviewsRedetermination LettersLegal InquiriesAdministrative RequestsWorkload Analysis
About the role
Key responsibilities & impact- Perform non-medical reviews and process redetermination letters, ensuring timeliness and accuracy
- Prepare unit reports, analyze and interpret workload, and process issues using various software tools
- Update letters and documents within the department when necessary
- Gather and prepare documentation for legal inquiries and administrative requests when needed
Requirements
What you’ll need- High School Diploma or equivalent
- 2 years job related field experience
- 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
- Proficiency in Microsoft Office
- CMS Security Clearance required
- This position is not eligible for sponsorship now or in the future
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
- Supplemental pay until enrolled in health benefits 28 days after the hire date