Job Description
This position is full time (40 hours/week) Monday-Friday and will be fully remote (South Carolina W@H). One week of onsite training required at 4101 Percival Rd Columbia, SC 29229, followed by three weeks of remote training with the team. The role involves pulling data from multiple Blue Cross systems (Rumba, Blueview, Cohere) and creating reports that summarize member healthcare spending and high-cost claims. It's a structured, repetitive role with consistent daily tasks, clear processes, and deadlines. The individual is responsible for maintaining the outpatient authorization process, reviewing/determining eligibility, and interpreting rules/regulations, while documenting the process and decisions accurately in the system. Effective business relationships with primary care physician offices and providers are essential.
About BlueCross BlueShield
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment.