Company · 288 open roles
Careers at Ourhrconnect
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288 positions at Ourhrconnect
Behavioral Health Intensive Care Management Coordinator (Low-Country, SC)
Ourhrconnect·W@H South Carolina
Summary We are currently hiring for an Intensive Care Management Coordinator to join BlueCross BlueShield of South Carolina. In this role as an Intensive Care Management Coordinator, you will serve as an Intensive Case Manager (ICM) for members identified with specific conditio…
Internal Financial Controls Analyst
Ourhrconnect·Columbia, South Carolina
Summary This is a full-time position reporting to 51 Clemson Road in Columbia, SC. This position does have the opportunity to be hybrid. You must be able to report to the Columbia office. This position will focus primarily on Financial Auditing and Compliance. Supports the M…
Behavioral Health Senior Medical Reviewer (South Carolina)
Ourhrconnect·W@H South Carolina
Summary We are currently hiring for a Senior Medical Reviewer to join BlueCross BlueShield of South Carolina. In this role as a Senior Medical Reviewer, you will act as Team Lead for specialty programs, medical review, utilization management, and case management areas by provid…
Auditor I - Medicare Cost Report
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 large…
Medicare Cost Reporting Auditor III
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 remote position working Mond…
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…
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…
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…
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…
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…
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 …
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…
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…
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, –…
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 …