CGS Administrators

SummaryResearches the substance of complex appeal or retrospective review requests including pre-pay and post-payment review appeal requests. Provides thorough clinical review or benefit analysis to determine if the requested services meet medical necessity guidelines. Documents deci

SummaryResearches the substance of complex appeal or retrospective review requests including pre-pay and post-payment review appeal requests. Provides thorough clinical review or benefit analysis to determine if the requested services meet medical necessity guidelines. Documents deci

SummaryResponsible 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. Reviews assi

SummaryResponsible 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. Reviews assi

SummaryProvides all redetermination case file information within the specified time requirement while maintaining accuracy and departmental standards. Suspends claims in applicable claim system and tracks all data.DescriptionLogisticsCGS one of BlueCross BlueShields South Carolina sub

SummaryProvides all redetermination case file information within the specified time requirement while maintaining accuracy and departmental standards. Suspends claims in applicable claim system and tracks all data.DescriptionLogisticsCGS one of BlueCross BlueShields South Carolina sub

SummaryUnder general supervision performs a variety of routine to moderately complex clerical/accounting functions such as inventory balancing reconciliations generating refund request letters processing disbursements and deposits keying journal entries and logging items in accordance

SummaryUnder general supervision performs a variety of routine to moderately complex clerical/accounting functions such as inventory balancing reconciliations generating refund request letters processing disbursements and deposits keying journal entries and logging items in accordance

SummaryWorking at CGS Administrators LLCCGS Administrators LLC (CGS) is part of BCBSSCs 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

SummaryWorking at CGS Administrators LLCCGS Administrators LLC (CGS) is part of BCBSSCs 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

SummaryWorking at CGS Administrators LLCCGS Administrators LLC (CGS) is part of BCBSSCs 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

SummaryWorking at CGS Administrators LLCCGS Administrators LLC (CGS) is part of BCBSSCs 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

SummaryWhy should you join the BlueCross BlueShield of South Carolina family of companies Other companies come and go but for more than seven decades weve been part of the national landscape with our roots firmly embedded in the South Carolina community. We are the largest insurance c

SummaryWhy should you join the BlueCross BlueShield of South Carolina family of companies Other companies come and go but for more than seven decades weve been part of the national landscape with our roots firmly embedded in the South Carolina community. We are the largest insurance c

SummaryResponsible for conducting investigations preparing reports work papers and performing vulnerability assessments to recognize and identify potential compliance issues. Provides guidance to management and employees as needed. May be responsible for developing and presenting comp

SummaryResponsible for conducting investigations preparing reports work papers and performing vulnerability assessments to recognize and identify potential compliance issues. Provides guidance to management and employees as needed. May be responsible for developing and presenting comp

SummaryDescriptionWhy should you join the BlueCross BlueShield of South Carolina family of companies Other companies come and go but weve 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

SummaryDescriptionWhy should you join the BlueCross BlueShield of South Carolina family of companies Other companies come and go but weve 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

SummaryWorking at CGS AdministratorsCGS Administrators LLC (CGS) is part of BCBSSCs 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 Medi

SummaryWorking at CGS AdministratorsCGS Administrators LLC (CGS) is part of BCBSSCs 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 Medi

SummaryOversees the accurate processing of claims that have been deferred for medical necessity review. Ensures compliance with nationally recognized standards and local state and federal laws and regulations. Identifies and implements process improvement opportunities.DescriptionWhy

SummaryOversees the accurate processing of claims that have been deferred for medical necessity review. Ensures compliance with nationally recognized standards and local state and federal laws and regulations. Identifies and implements process improvement opportunities.DescriptionWhy

SummaryDescriptionWhy should you join the BlueCross BlueShield of South Carolina family of companies Other companies come and go but for more than seven decades we have been part of the national landscape with our roots firmly embedded in the South Carolina community. We are the large

SummaryDescriptionWhy should you join the BlueCross BlueShield of South Carolina family of companies Other companies come and go but for more than seven decades we have been part of the national landscape with our roots firmly embedded in the South Carolina community. We are the large

SummaryReviews 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.DescriptionLogistics:CGS ()one of BlueCross BlueShields South Carolina sub

SummaryReviews 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.DescriptionLogistics:CGS ()one of BlueCross BlueShields South Carolina sub

SummaryWorking at CGS AdministratorsCGS Administrators LLC (CGS) is part of BCBSSCs 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 Medi

SummaryWorking at CGS AdministratorsCGS Administrators LLC (CGS) is part of BCBSSCs 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 Medi