Company · 265 open roles
Careers at Ourhrconnect
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265 positions at Ourhrconnect
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…
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 …
Medical Director (Medicare Policy)
Ourhrconnect·W@H Tennessee
Summary Analyzes medical review utilization data, researches new medical procedures or technology, and acts as a lead resource to providers and internal staff on issues concerning medical policies. Heavily involved in policy generation to include the development of new policy a…
Molecular Diagnostics Medicare Medical Director - Palmetto GBA
Ourhrconnect·W@H 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 large…
Senior Quality Assurance Analysts
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 …
HRIS System Analyst I
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 largest…
Representative, Provider Relations
Ourhrconnect·Columbia, South Carolina
Summary Provides education and training support for network providers, staff, suppliers, physicians, beneficiaries, referral agents as necessary. Develops and produces training and educational materials. Description Logistics: BlueCross BlueShield of South Carolina - About U…
Pharmacy Technician - Prior Authorization Focus
Ourhrconnect·Columbia, South Carolina
Summary Responsible for setting up cases for pharmacy authorization requests and performing pharmacy reviews as per established criteria. Maintains the timely, complete, and accurate processing of authorization requests by interfacing with internal and external customers and th…
Client Relationship Manager I
Ourhrconnect·Columbia, South Carolina
Summary Serves as the day to day lead in the client issues, service resolution of assigned accounts. Works with management and internal stakeholders on client specific or departmental initiatives. Description Location: This position is full-time (40-hours/week) Monday-Friday …
Provider File Specialist II
Ourhrconnect·Columbia, South Carolina
Summary Responsible for the maintenance of all provider files through assignment and enrollment on specified provider systems/databases. Responsible for running various queries for reporting on corporate, division, and department levels. Description Logistics: Palmetto GBA, –…
Senior Proposal Strategist- Hybrid, Columbia, South Carolina
Ourhrconnect·Columbia, South Carolina
Summary This high-level proposal resource will participate in winning and retaining large clients, primarily designated to strategic RFPs and RFIs with a focus on strategy, storytelling, and high-quality responses. This role will collaborate with sales and account management re…
Accounting Technician II (EFT Processor)
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 …
Accountant I
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 …
RN Medical Reviewer II - Palmetto GBA
Ourhrconnect·W@H South Carolina
Summary Performs medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical c…
Accountant III-CDS
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 for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. We…
Customer Service Advocate II
Ourhrconnect·Columbia, South Carolina
Summary Provides prompt, accurate, thorough and courteous responses to all customer inquiries. Inquiries may be non-routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Description Location: This posit…
Appeals Coordinator
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…
Operations Manager-2
Ourhrconnect·Florence, South Carolina
Summary Manages the daily activities of a multi-functional area. Responsible for monitoring productivity, attendance and quality of work produced. Responsible for motivating associates to meet individual and departmental goals. Description Why should you join the BlueCross Bl…
Developer IV - CGS Administrators, LLC (Nashville, TN)
Ourhrconnect·Nashville, Tennessee
Summary CGS Administrators, LLC (CGS) is part of BCBSSC™'s Celerian Group of companies and provides a variety of services for Medicare beneficiaries, healthcare providers, and medical equipment suppliers in 38 states, supporting the needs of over 8.7 million Medicare beneficiar…
Claims Processor I - PGBA
Ourhrconnect·Florence, South Carolina
Summary We are currently hiring for a Claims Processor I to join BlueCross BlueShield of South Carolina. You will be responsible for the accurate and timely processing of claims. Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companie…