Company · 288 open roles
Careers at Ourhrconnect
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288 positions at Ourhrconnect
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…
Mail Sorter Operator (Night Shift)
Ourhrconnect·Columbia, South Carolina
Summary Process mail by priority, based on contractual mail date, and finalize mailings for United States Postal Service (USPS) acceptance. Input sort schemes to the sorter system to obtain the best possible postage rates allowed. **Sorter operators follow strict guidelines t…
Claims Processor I
Ourhrconnect·Myrtle Beach, 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 e…
Claims Processor II
Ourhrconnect·Columbia, South Carolina
Summary Reviews and adjudicates complex or specialty claims. Determines whether to return, deny or pay claims following organizational policies and procedures. Assists in training or mentoring new staff members. Description Position Purpose Reviews and adjudicates complex or …
Claims Customer Service Advocate II
Ourhrconnect·Columbia, South Carolina
Summary Responsible for responding to routine correspondence and telephone inquiries pertaining to claims or appeals. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Description Logistics: PGBA – is a subsidiary company of …
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…
Medical Review Manager
Ourhrconnect·Myrtle Beach, South Carolina
Summary We are currently hiring for a Medical Review Manager to join BlueCross BlueShield of South Carolina. In this role as a Medical Review Manager, you will oversee the accurate processing of claims that have been deferred for medical necessity review. Ensures compliance wit…
Food Services Specialist 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. Why should you join the BlueCross BlueShield of South Carolina fa…
Specialist, Subrogation
Ourhrconnect·Columbia, South Carolina
Summary Identifies and pursues subrogation and workers compensation recoveries. Manages a workload of approximately 500 cases and the collection of approximately $1,000,000 annually. Description Why should you join the BlueCross BlueShield of South Carolina family of companie…
Lead Medicare Cost Reporting Auditor
Ourhrconnect·Columbia, South Carolina
Summary Responsible for the coordination and completion of the audit reviews, reviewing audit work papers and reports completed by department staff, distributing reports to management, coordinating auditor’s assignments, mentoring and coaching department staff, and assisting th…
Director, Ancillary Sales & Marketing Representative with Companion Life - Onsite Columbia, South Carolina
Ourhrconnect·W@H Kansas
Summary Leads corporate distribution systems, general agents, brokers, and other market support personnel. Responsible for planning, product development, marketing services, production and profitability for as few as two states to regions with as many as ten states. Customarily…
Medicare Cost Reporting Auditor II
Ourhrconnect·W@H 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 remote position working Monda…
Associate Actuary
Ourhrconnect·Columbia, South Carolina
Summary Description Summary BlueCross BlueShield of South Carolina seeks an Associate Actuary for its Columbia, SC location. This position is not eligible for sponsorship now or in the future. There are multiple positions available. Why should you join the BlueCross BlueSh…
Developer IV (Technical Team Lead) - PGBA
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…
Sales Excellence Manager
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 sales training staff. Description Location: This position is full-time (40-hours/week) Monday-Friday in a typical o…
Processor, Claims I
Ourhrconnect·Myrtle Beach, 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…
RN Senior Medical Reviewer (South Carolina)
Ourhrconnect·W@H South Carolina
Summary We are currently hiring for an RN Senior Medical Reviewer to join BlueCross BlueShield of South Carolina. In this role as an RN Senior Medical Reviewer, you will act as Team Lead for specialty programs, medical review, utilization management, and case management areas b…
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…
Utilization Management 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 …
Contract Administration Manager
Ourhrconnect·Columbia, South Carolina
Summary Responsible for managing contract staff and administration of all contracts to ensure that contractual obligations are met and compliance is maintained with mandatory governmental regulations, applicable laws and corporate policies and procedures. Ensures effective rela…
Behavioral Health Medical Director
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…
Physical Medicine and Rehabilitation Medical Director
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…
Physical Medicine and Rehabilitation Medical Director
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…
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…