Company · 265 open roles
Careers at Ourhrconnect
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265 positions at Ourhrconnect
RN Managed Care Coordinator I
Ourhrconnect·W@H South Carolina
Summary We are currently hiring for a Managed Care Coordinator I to join BlueCross BlueShield of South Carolina. In this role as a Managed Care Coordinator I, you will review and evaluate medical or behavioral eligibility regarding benefits and clinical criteria by applying cli…
Accreditation Data Coordination Analyst
Ourhrconnect·Columbia, South Carolina
Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the larges…
Strategic Account Executive with National Alliance - Hybrid
Ourhrconnect·Columbia, South Carolina
Summary The Strategic Account Executive (SAE) is responsible for the retention, growth, and overall strategic management of an assigned portfolio of health plan, employer group, consultant, and partner relationships. The SAE serves as the primary client advocate, ensuring succe…
Bilingual Customer Service Phone Advocate
Ourhrconnect·Florence, South Carolina
Summary Provides prompt, accurate, thorough and courteous responses to all telephone inquiries. Performs research as needed to resolve inquiries. Description 65% Ensures effective customer relations by responding accurately, timely and courteously to telephone inquiries. Accu…
Auditor II (DME Accreditation)
Ourhrconnect·Columbia, South Carolina
Summary Responsible for providing a full range of financial, compliance, and operational audits, business advisory and consultation services, investigations, internal controls, accountability, and use of resources. Description This is a full-time position working in Columbia,…
Claims Customer Service Advocate II
Ourhrconnect·Columbia, South Carolina
Summary Responsible for responding to customer inquiries. Inquiries may be non-routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals. Determines w…
Clinical Pharmacist
Ourhrconnect·Columbia, South Carolina
Summary Responsible for performing comprehensive medication reviews and outreach to inform and educate patients and their providers about opportunities to optimize medication related outcomes, ensure patient safety, and utilize cost effective therapies. Collaborates with other …
RN Behavioral Health Concierge Care Manager
Ourhrconnect·W@H South Carolina
Summary We are currently hiring for an RN Behavioral Health Concierge Care Manager to join BlueCross BlueShield of South Carolina. In this role as an RN Behavioral Health Concierge Care Manager, you will provide care management services to more than 2 million members in South C…
Group Sales Administrator - Hybrid Columbia, South Carolina
Ourhrconnect·Columbia, South Carolina
Summary Serves as liaison to customers, agents, agencies, group leaders, marketing, underwriting, and operations to ensure appropriate documentation is received for accurate and timely processing. Verifies all group submissions are in compliance with BCBS underwriting rules and…
Customer Service Advocate III
Ourhrconnect·Columbia, South Carolina
Summary Provides prompt, accurate, thorough and courteous responses to all complex customer inquiries. Inquiries are typically non-routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Description Locat…
Claims Processor I
Ourhrconnect·Florence, South Carolina
Summary Responsible for the accurate and timely processing of claims. Description Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with o…
Claims Processor I
Ourhrconnect·Columbia, South Carolina
Summary Responsible for the accurate and timely processing of claims. Description Logistics: PGBA – one of BlueCross BlueShield's South Carolina subsidiary companies Location: This position is full-time (40-hours/week) Monday-Friday from 8am-5pm in a typical office environme…
Bilingual Customer Service Phone Advocate
Ourhrconnect·Florence, South Carolina
Summary Provides prompt, accurate, thorough and courteous responses to all telephone inquiries. Performs research as needed to resolve inquiries. Description Location: This position is full-time (40-hours/week) Monday-Friday in a typical office environment. This role is locat…
Training Specialist II
Ourhrconnect·Columbia, South Carolina
Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest…
Claims Customer Service Advocate I
Ourhrconnect·Columbia, South Carolina
Summary Responsible for responding to routine inquiries. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, deny or pay claims following org…
Customer Service Advocate II
Ourhrconnect·Columbia, South Carolina
Summary This role directly helps our customers in a timely, prompt, thorough, courteous and accurate way to answer some of their most worrisome health care questions and concerns. This job can be complex and may require research as well as the ability to feel comfortable going …
Specialist, Appeals
Ourhrconnect·Florence, South Carolina
Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest…
Medical Reviewer I - Remote after 6 months
Ourhrconnect·Myrtle Beach, South Carolina
Summary Join our team serving active and retired US military members and their covered family members. We strive to ensure that these dedicated individuals and their loved ones receive high-quality care administered as economically as possible and in accordance with current evi…
Technical Team Lead - CICS
Ourhrconnect·Columbia, South Carolina
Summary Companion Data Services provides leading IT solutions and managed services. We operate multiple geographically disperse data centers, including two of the nation’s largest healthcare data centers – both rated among the top five percent of data centers worldwide by MIPS.…
Enterprise Technical Architect - IBM z/OS Storage
Ourhrconnect·Columbia, South Carolina
Summary Companion Data Services provides leading IT solutions and managed services. We operate multiple geographically disperse data centers, including two of the nation’s largest healthcare data centers – both rated among the top five percent of data centers worldwide by MIPS.…
Technician, Accounting III
Ourhrconnect·Columbia, South Carolina
Summary Description Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We …
Operations Analyst
Ourhrconnect·Columbia, South Carolina
Summary Under general supervision, analyzes proposed policies, procedures, forms, and reports. Recommends operational improvement through standardization, simplification, discontinuance and other methods. Recommends installations of new systems/procedures. Reviews organizationa…
Senior Quality Assurance Analyst
Ourhrconnect·Florence, South Carolina
Summary Performs quality control audits to evaluate accuracy and effectiveness of departmental operations functions including, but not limited to, claims, membership, customer service/call center, workflow, processing support systems, procedures, documentation, etc. Identifies …
Manager, Underwriting
Ourhrconnect·Columbia, South Carolina
Summary Oversees the day-to-day underwriting operations including budget and staff planning as well as direct supervision of personnel to successfully accomplish company underwriting objectives and compliance. Identifies, analyzes, and manages the assigned line of business for …