Company · 197 open roles
Careers at Ourhrconnect
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197 positions at Ourhrconnect
Statistical Programming Analyst I- Palmetto GBA
Ourhrconnect·Columbia, South Carolina
Summary Job Description Summary Palmetto GBA is one of the nation’s largest providers of high-volume claims and transaction processing, contact center operations, and technical services to the federal government and other commercial customers. Our core business is providing ser…
Entry Level Cost Auditor
Ourhrconnect·Springfield, Illinois
Summary Responsible for assisting in the execution of financial, compliance, and operational audits including evaluation of internal controls. Audits the activity of various departments and providers for compliance with plans, policies, and procedures prescribed by management. …
RN Case Management Coordinator
Ourhrconnect·W@H South Carolina
Summary We are currently hiring for an RN Case Management Coordinator to join BlueCross BlueShield of South Carolina. In this role as an RN Case Management Coordinator, care management interventions focus on improving care coordination and reducing the fragmentation of the serv…
Appeals Director
Ourhrconnect·Columbia, South Carolina
Summary Provides direction and guidance to appeals, customer service, and claims processing staff for multiple operational areas. We strongly prefer experience in FISS, MAS, PECOS, and HIGLAS and management in a Medicare Administrative Contractor operational setting. Descript…
Senior Stop Loss Claims Auditor
Ourhrconnect·Columbia, South Carolina
Summary Audit and authorize reimbursement of specific medical stop loss claims. Effectively mitigate client medical stop loss claims and provide excellent customer service. Description Position Purpose Audit and authorize reimbursement of specific medical stop loss claims. Ef…
Bilingual Community Outreach Specialist
Ourhrconnect·Columbia, South Carolina
Summary Cultivates relationships with key partners, stakeholders, and influencers in the community. Delivers presentations, attends community events/meetings, and distributes materials. Works with corporate communications team. Ensures activities are updated, distributed, and i…
Manager, Large Group Market
Ourhrconnect·Columbia, South Carolina
Summary Within assigned division, manages various projects and provides management/functional staff support in order to meet sales and retention goals. Manages administrative/support staff, Service Representatives/Agents. Would be expected to be visible in the market with cli…
Concierge Care Manager
Ourhrconnect·Columbia, South Carolina
Summary Provides care management services to more than 2 million members in South Carolina and nationally. Administers complex, high-touch concierge case management for members identified into specialized programs such as high-risk maternity, NICU, ESRD, Cancer, Palliative Care…
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 …
AVP, Institutional Contracting
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 large…
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 …
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…
Automation Specialist
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 largest…
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 8:00am-5:00pm in a typical office en…
Bilingual Customer Services Advocate II
Ourhrconnect·Columbia, South Carolina
Summary Provides prompt, accurate, thorough and courteous responses to all customer inquiries. Inquires may be non-routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Description Location: This is a f…
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 …
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 …
Director, Claims Customer Service
Ourhrconnect·Augusta, Georgia
Summary Provides direction and guidance to customer service, claims processing, and/or appeals staff for multiple operational areas. Description Logistics: Palmetto GBA – one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is full-tim…
Specialist, Food Services I
Ourhrconnect·Columbia, South Carolina
Summary Depending on department needs, this job includes the following: cashier, prep cook, food server, dishwasher/pot washer, catering delivery, restocking as needed, and any other need as asked by management. Sponsorship: This position is not eligible for sponsorship now or…
Compensation Analyst
Ourhrconnect·Columbia, South Carolina
Summary Responsible for providing support for day-to-day compensation operations. Perform various activities including conducting basic compensation research; reviewing and processing requests in Human Capital Management (HCM) system, HCM system standardization, and maintenance…
Claims Processor I
Ourhrconnect·Florence, 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 8:00am-5:00pm. This role is located …
AVP - Medicaid Healthcare Management
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 large…
Accountant I (Medicare)
Ourhrconnect·Columbia, South Carolina
Summary Responsible for entry level accounting activities relating to the maintenance of a complete and accurate general ledger and/or the resultant managerial reports and/or financial statements. Description Why should you join the BlueCross BlueShield of South Carolina fami…
Claims Processor I
Ourhrconnect·Florence, South Carolina, United States
Claims Processor I at Ourhrconnect. Location: Florence, South Carolina, United States. Role: processing claims, verifying coding, resolving edits Requirements: High school diploma or equivalent, strong analytical/communication skills, basic business math, ability to obtain securi…