Coordinator, Appeals

Summary:

The Appeals Coordinator role focuses on reviewing and screening appeals to ensure they are assigned to the correct document type, including researching requests, entering the appropriate data to identify case specifics, and building appeal cases in the system.

The role ensures appeals are correctly processed and documented.

Palmetto GBA – one of Blue Cross Blue Shield’s South Carolina subsidiary companies.

Full‑time, Monday‑Friday, 8:00am‑5:00pm at 200 Dozier Blvd, Florence, SC 29501 or 17 Technology Circle, Columbia, SC 29203.

This position requires CMS Security Clearance.

As a Service Contract Act (SCA) employee, you are required to enroll in our health insurance within 28 days of full‑time employment. Until enrollment is complete, supplemental pay for health coverage is provided.

Not eligible for sponsorship now or in the future.

• Research requests, enter appropriate data to identify case specifics, and build appeal cases in the system.
• Log requests to appropriate functional area, generate letters, assemble files, order records, and obtain additional information as directed.
• Ensure quality control of all appeals, pend documents for electronic storage, and prepare case files for review and/or further routing.

• High School Diploma or equivalent.
• 1 year administrative support/clerical or related experience.
• Proficiency in word processing and spreadsheet software.
• Effective organizational and customer service skills.
• Good judgment, strong spelling, punctuation, and grammar skills.
• Strong written and verbal communication skills.
• Proficiency in Microsoft Office.

• 3 years claims, customer service, or healthcare program management experience.
• Ability to persuade, negotiate, or influence.
• Knowledge of Microsoft Access or other database software.

Typical office environment.

• Subsidized health plans, dental and vision coverage.
• 401(k) retirement savings plan with company match.
• Life insurance.
• Paid Time Off (PTO).
• On‑site cafeterias and fitness centers in major locations.
• Wellness program and healthy lifestyle premium discount.
• Tuition assistance.
• Service recognition.
• Employee assistance.
• Discounts to movies, theaters, zoos, theme parks, and more.

Blue Cross Blue Shield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of ag