Technician, Accounting II (Medicare) Palmetto GBATechnician, Accounting II (Medicare)Columbia, South CarolinaWe are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. Prepares various financial data associated with refunds, invoices, recoupments, adjustments, cash disbursements, deposits, check voids and reissues, disputes, correspondence, or other data in support of the finance or accounting function.
Remote role Healthcare Business Analyst Syntricate Technologies IncRemote role Healthcare Business AnalystColumbia, SCRemoteThe current position’s focus and priority is the continued support of serving as a subject matter expert (SME), utilizing knowledge of medical coding and MMIS to support change requests while ensuring change requests and system updates result in the expected claims adjudication outcomes for the benefit of Medicaid members and providers. This project is an immediate support need that will primarily focus on providing consulting services to operations and policy staff for the current medical coding federal requirements, quarterly and intermittently, and all coding changes associated with agency initiatives to ensure compliance policy and code change alignment.
Clinical Analyst & Coding Specialist Sunshine Enterprise USAClinical Analyst & Coding SpecialistColumbia, South CarolinaThe consultant will serve as a Subject Matter Expert (SME) for medical coding, Medicaid policy, and business analysis while collaborating with business and technical teams to support coding updates, policy implementation, and business process improvements. Seeking an experienced Business Analyst (Clinical Analyst & Coding Specialist) to support ongoing Medicaid operations and healthcare system initiatives.
Clinical Analyst & Coding Specialist - Contract - Columbia, SC Sunshine Enterprise UsaClinical Analyst & Coding Specialist - Contract - Columbia, SCColumbia, South CarolinaThe consultant will serve as a Subject Matter Expert (SME) for medical coding, Medicaid policy, and business analysis while collaborating with business and technical teams to support coding updates, policy implementation, and business process improvements. Seeking an experienced Business Analyst (Clinical Analyst & Coding Specialist) to support ongoing Medicaid operations and healthcare system initiatives.
Appeals and Grievances Clinical Specialist HealthfirstAppeals and Grievances Clinical SpecialistSC$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. Prepare cases for Medical Director Review ensuring that all pertinent information (i.e. case summary, contract information, internal and external responses, diagnosis, and CPT codes and descriptions) has been obtained during investigation and is presented as part of the case.
A&G Clinical Specialist HealthfirstA&G Clinical SpecialistSC$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances Clinical Specialist is responsible for receiving, investigating and responding verbally and in writing to member and provider clinical appeals and grievances. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798.
Pharmacy Billing Technician / Program Coordinator I (Finance- Central Office) State of South CarolinaPharmacy Billing Technician / Program Coordinator I (Finance- Central Office)Lexington, SC$45,300–$61,100 / yearThe Department of Behavioral Health and Developmental Disabilities offers an exceptional benefits package for full time (FTE) employees: Health, dental, vision, long-term disability, and life insurance for employees, spouse, and children. In this role, you will ensure timely and accurate processing of claims for William S Hall Inpatient Psychiatric Hospital and make sure all room and board and physician billing is completed monthly.
Technician, Accounting II (Medicare) BlueCross BlueShield of South CarolinaTechnician, Accounting II (Medicare)Columbia, South CarolinaWe are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. Prepares various financial data associated with refunds, invoices, recoupments, adjustments, cash disbursements, deposits, check voids and reissues, disputes, correspondence, or other data in support of the finance or accounting function.
Bilingual Customer Service Advocate II BlueCross BlueShield of South CarolinaBilingual Customer Service Advocate IIColumbia, South CarolinaWe are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, or walk-in inquiries.
NewQuality Medical Auditor BlueCross BlueShield of South CarolinaQuality Medical AuditorColumbia, South CarolinaRequired Licenses and Certificates: Registered Records Administrator or Technician, OR, active, unrestricted RN licensure from the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC), OR Certified Coding Specialist. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.
Project Manager (MES Modernization Program) Sunshine Enterprise USAProject Manager (MES Modernization Program)Columbia, South CarolinaThe consultant will serve as a key member of the Program Management Office (PMO), responsible for project schedule management, planning, governance, reporting, risk management, and oversight of vendor-delivered project activities. The role will support the successful execution of modernization efforts by ensuring project schedules, deliverables, resources, and dependencies are effectively managed throughout the project lifecycle.
IT Business Analyst II / 60019068 State of South CarolinaIT Business Analyst II / 60019068Richland County, SCRemote$52,100–$88,600 / yearThe South Carolina Department of Health and Human Services offers an exceptional benefits package for FTE and TGE positions that includes: Health, Dental, Vision, Long Term Disability, and Life Insurance for Employee, Spouse, and Children. As such, the Information Systems/Business Analyst is responsible for activities supporting MMIS operational activities including reporting and analytics, systems support, testing, and coordination with business users.
Inpatient Medical Coder # 26-17687 US Tech Solutions, Inc.Inpatient Medical Coder # 26-17687Columbia, SC$36 / hourCreates monthly/quarterly reports to present to each line of business providing information on records review, outcomes, trends, and savings that directly impact medical costs and contracting rates. US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.
Psychologist - (Part-time) - Columbia, SC Commonwealth Medical ServicesPsychologist - (Part-time) - Columbia, SCColumbia, South Carolina$600–$750 / yearConduct one-time psychological and behavioral health evaluations for Veterans as part of the disability claims process • Perform clinical interviews, mental health assessments, and comprehensive record reviews • Assess psychiatric and psychological conditions in support of Veteran disability evaluations • Work in a low-volume setting, typically seeing 1–5 Veterans per day • Complete documentation electronically through a secure platform • Receive fully provided technology, training, and clinical support. • No ongoing therapy or counseling sessions • No treatment planning or long-term patient management • No prescribing responsibilities • No disability rating calculations or benefits determinations • No scheduling responsibilities or walk-in patients • No nights, weekends, holidays, or on-call responsibilities.
Psychologist - (Part-Time) - Columbia, SC Commonwealth Medical ServicesPsychologist - (Part-Time) - Columbia, SCColumbia, SC$600–$750 / yearConduct one-time psychological and behavioral health evaluations for Veterans as part of the disability claims process • Perform clinical interviews, mental health assessments, and comprehensive record reviews • Assess psychiatric and psychological conditions in support of Veteran disability evaluations • Work in a low-volume setting, typically seeing 1–4 Veterans per day • Complete documentation electronically through a secure platform • Receive fully provided technology, training, and clinical support. • No ongoing therapy or counseling sessions • No treatment planning or long-term patient management • No prescribing responsibilities • No disability rating calculations or benefits determinations • No scheduling responsibilities or walk-in patients • No nights, weekends, holidays, or on-call responsibilities.
Senior Applied & Agentic AI Engineer Sedgwick Claims Management Services, Inc.Senior Applied & Agentic AI EngineerSCNewsweek Recognizes Sedgwick as Americas Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance. Design secure tool integration layers connecting agents to claims systems, policy platforms, data warehouses, document repositories, and external data services.
Customer Liaison Chubb LtdCustomer LiaisonColumbia, SC$115,000–$135,000 / yearThe Customer Liaison will collaborate with internal and external partners (Sales, Underwriting, Actuarial, claims leadership, Product Development, brokers and affinity partners) to understand customer needs and drive the execution of new and existing claim support, service deliverables, technology capabilities and service to these customers. Provide timely and informative responses to sales leaders, brokers, and employer groups regarding claims; collaborate with internal and external partners on issues affecting key accounts including close management and monitoring of at-risk cases.
Life Insurance Agent Alchemy Financial GroupLife Insurance AgentColumbia, SCAs an Insurance Agent with [Alchemy Group Financial], you'll be responsible for selling policies to clients, handling claims, and keeping track of policy renewals. Identify opportunities to sell life insurance to a variety of clients and working with them to find the policy that best suits their needs.
Customer Service Representative - State Farm Agent Team Member David Strawhorn - State Farm AgentCustomer Service Representative - State Farm Agent Team MemberColumbia, SCFull timeAs a Customer Service Representative - State Farm Agent Team Member with David Strawhorn - State Farm Agent, you will generate the kind of exceptional customer experiences that reinforce the growth of a successful insurance agency. You will enhance your career while resolving customer inquiries, coordinating with other agency team members, and anticipating the needs of the community members you support.
Customer Service Representative - State Farm Agent Team Member Ryan Grubbs - State Farm AgentCustomer Service Representative - State Farm Agent Team MemberLexington, SCFull timeAs a Customer Service Representative - State Farm Agent Team Member with Ryan Grubbs - State Farm Agent, you will generate the kind of exceptional customer experiences that reinforce the growth of a successful insurance agency. I started my State Farm career right out of college as a team member, and that experience gave me a deep appreciation for what it takes to build a successful, customer-focused office.