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001 Blue Cross And Blue Shield Of South Carolina

Specialist, Appeals

Nashvillehybridmid

Posted today · via Workday

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About this role

Summary Performs non-medical reviews and processes redetermination letters. Description Logistics: CGS –one of BlueCross BlueShield's South Carolina subsidiary companies. Location : This position is hybrid schedule 3 days onsite reporting at 26 Century Blvd Suite ST610 Nashville, TN 37214 and two days remote, this is a full-time role (40 hours/week) Monday-Friday. As an Appeals Specialist, you'll be at the forefront of patient advocacy, reviewing and managing redeterminations and first-level appeals with precision and care. Your daily work involves analyzing comprehensive documentation, identifying missing information, ensuring timely processing, and making decisions that directly impact healthcare outcomes.…

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What we'd score you on

reqspace match rubric

Five dimensions, recruiter-grade. Upload your resume and we'll generate a written explanation of where you fit and where the gaps are.

1

Skills match

We compare your skills against the role requirements.

2

Level fit

This role is mid-level. We check your trajectory against it.

3

Domain experience

Your work in the role's domain matters more than your years total. We weight recent and direct experience.

4

Recency

A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.

5

Location fit

This role is based in Nashville. We weight your proximity and willingness to relocate.

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