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Blue Cross Blue Shield

Senior Provider Enrollment Analyst – Palmetto GBA

Columbia, SC 29203

Summary Acts as a Team Lead by providing guidance/direction/training to Provider Enrollment Analysts and/or other Provider Enrollment area staff. Responsible for the processing of difficult enrollment applications and/or complex inquiries. Description Logistics: Palmetto GBA – one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This is a full-time (40-hours/week) Monday-Friday position located onsite at 17 Technology Circle, Columbia, SC, 29203. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-5:00PM. It may be necessary, given the business need to work occasional overtime. What You’ll Do: Functions as Team Leader/senior-level Enrollment Analyst. Provides leadership/guidance/direction/training to staff. Distributes work and is available to answer questions from staff. Acts as a resource for staff regarding any escalating issues. Keeps manager informed of any problems/issues that need resolving. Conducts quality reviews of completed work. Ensures that all audits are completed, verified, and closed. Performs analysis of audits to determine areas for training, development, and education. Ensures that quality work instructions/forms/documents are developed/revised as needed. Provides quality service and communicates effectively with external/internal customers in response to inquiries (correspondence, telephone). Obtains information from internal departments, providers, government and/or private agencies, etc. to resolve discrepancies/problems. Interprets various guidelines and provides input to required procedures. Generates and analyzes various provider reports to management. Participates in testing system changes related to provider files. Contributes/participates/completes special projects as assigned. To Qualify for this Position, You’ll Need the Following: Required Education: 4 years job related work experience or Associate's and 2 years job related work experience. Required Work Experience: 2 years of provider network enrollment/certification experience. Required Skills and Abilities: Working knowledge of word processing, spreadsheet, and database software. Working knowledge of provider certification process and claims processing operations/systems. Good judgment skills required. Effective customer service, organizational, and presentation skills required. Demonstrated verbal and written communication skills. Demonstrated proficiency in spelling, punctuation, and grammar skills. Basic business math proficiency required. Analytical or critical thinking skills required. Ability to handle confidential or sensitive information with discretion. In-depth knowledge of pricing methodology and discount programs. In-depth knowledge of Medicare program instructions/regulations related to provider enrollment/issues. Required Software and Tools: Microsoft Office. We Prefer That You Have the Following : Medicare Part A/B MAC experience Proficient with PECOS and IFLOW What We Can Do for You: We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company. Our comprehensive benefits package includes the following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment. Subsidized health plans, dental and vision coverage. 401k retirement savings plan with company match. Life Insurance. Paid Time Off (PTO). On-site cafeterias and fitness centers in major locations. Education Assistance. Service Recognition. National discounts to movies, theaters, zoos, theme parks and more. What to Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Equal Employment Opportunity Statement BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. 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. If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information . Some states have required notifications. Here's more information .

Posted 1 month ago

Blue Cross Blue Shield

Auditor I – Palmetto GBA

Columbia, SC 29203

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 insurance company in South Carolina … and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Position Purpose: Responsible for assisting in the execution of financial, compliance, and operational audits including evaluation of internal controls. Audit the activity of various departments and providers for compliance with plans, policies, and procedures prescribed by management. Review assigned portions of audit programs, determines compliance with policies and procedures, recommends corrective action plans, and prepares/submits reports on the results of audits. Description Logistics: Palmetto GBA – one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is full-time (40-hours/week) Monday-Friday working Remote in the U.S., or onsite at our 17 Technology Circle, Columbia, SC location. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-5:00PM. It may be necessary, given the business need to work occasional overtime. SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). Under the McNamara-O'Hara Service Contract Act (SCA), employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date. What You’ll Do: Conduct audits of the financial, management, and administrative procedures of assigned divisions, providers, departments, and various lines of businesses throughout the organization to ensure that procedures are in compliance. Audits include interviewing key personnel, conducting testing, evaluating internal controls, analyzing existing financial and management practices to determine effectiveness, and reviewing relevant documentation to support findings. Develop detailed reports on each audit conducted. Report includes a review of findings and an identification of recommendation to correct any deficiencies and methods for improvement to processes. Conducts testing of corrective actions as identified. Conduct special audit studies for management, such as those required to discover controls for prevention of fraud. Prepare reports of finding and recommendations for management. Assist other auditors in completing their assignments as a means of maximizing audit efficiency and thus reducing lost time and involvement of corporate personnel. To Qualify for This Position, You'll Need the Following: Required Education: Bachelor’s Degree in a job-related field (This position is open to students who are expected to graduate in May 2025) Required Work Experience: No previous work experience required. Required Software and tools: Microsoft Office Required Skills and Abilities: Knowledge of the principles and practices of auditing. Ability to analyze and determine the applicability of financial data. Ability to draw conclusions and make appropriate recommendations for analyzed data. Ability to gather information by examining records and documents and interviewing individuals. Strong interpersonal skills and the ability to work professionally with persons at all levels. Ability to communicate clearly and effectively in oral and written form. Ability to handle sensitive matters on a confidential basis. We Prefer That You Have the Following: • Bachelor's Degree with 12 credit hours of Accounting or Finance (You will need to provide your transcripts) • Strong Microsoft Excel skills • Certified Internal Auditor (CIA) or Certified Public Accountant (CPA) or Certified Information Systems Auditor (CISA). Our comprehensive benefits package includes the following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment. Subsidized health plans, dental and vision coverage 401k retirement savings plan with company match Life Insurance Paid Time Off (PTO) On-site cafeterias and fitness centers in major locations Education Assistance Service Recognition National discounts to movies, theaters, zoos, theme parks and more What We Can Do for You: We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company. What to Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Management will be conducting interviews with those candidates who are the most qualified, with prioritization given to those candidates who demonstrate the required qualifications. Equal Employment Opportunity Statement BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. 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. If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information . Some states have required notifications. Here's more information .

Posted 1 month ago

Blue Cross Blue Shield

Claims Customer Service Advocate II

Columbia, SC 29229

Summary We are currently hiring for a Claims Customer Service Advocate II to join BlueCross BlueShield of South Carolina. You will be 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 whether to return, deny or pay claims following organizational policies and procedures. 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 insurance company in South Carolina … and much more. We are one of the nation’s leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future. Description Position Purpose: This role is part of an inbound call center and directly helps our customers by responding to inquiries that may be non-routine and require deviation from standard screens, scripts and procedures. Research may be required to resolve these inquiries. Other responsibilities include review and adjudication of claims and/or non-medical appeals, determining whether to return, deny or pay claims while following policies and procedures. Location: This position is full-time (40 hours/week) Monday - Friday in a typical office environment. Employees are required to work a training and work schedule of 8:00am to 4:30. It may be necessary, given the business need to work occasional overtime and weekends. This role is located at 4101 Percival Road, Columbia SC. What You'll Do: You'll ensure effective customer relations by responding accurately, timely and courteously to our customers. These responses may be by telephone, written, web or walk-in inquiries. You will handle situations which may require a different set of responses or extensive research. Adhering to department guidelines, you will also identify claims that have been incorrectly processed and will enact process adjustments and reprocessing actions. You will examine and process claims and/or non-medical appeals while ensuring business/contract regulations, internal standards and examining guidelines. Another responsibility is to enter claims into the claim system after verifying correct coding of procedures and diagnosis codes. Claims must be processed according to established quality and production standards. You'll identify complaints and inquiries that may be complex and that cannot be resolved following usual procedures and guidelines and refer to a team lead or manager for resolution. You will also identify and report fraud and abuse situations. To Qualify for This Position, You'll Need: Required Education: High School Diploma or equivalent Required Work Experience: 2 years of customer service experience including 1 year claims or appeals processing OR Bachelor's Degree in lieu of work experience. Required Skills and Abilities : Good verbal and written communication skills. Strong customer service skills. Good spelling, punctuation and grammar skills. Basic business math proficiency. Ability to handle confidential or sensitive information with discretion. Required Software and Other Tools: Microsoft Office. Our Comprehensive Benefits Package Includes The Following 401(k) retirement savings plan with company match. Subsidized health plans and free vision coverage. Life insurance. Paid annual leave - the longer you work here, the more you earn. Nine paid holidays. On-site cafeterias and fitness centers in major locations. Wellness programs and a healthy lifestyle premium discount. Tuition assistance. Service recognition. What We Can Do for You: We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company. What to Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Equal Employment Opportunity Statement BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. 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. If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information . Some states have required notifications. Here's more information .

Posted 1 month ago

University of South Carolina

Research Impact Librarian

Richland, SC

Posting Number FAC00102PO25 Advertised Title Research Impact Librarian Campus Columbia College/Division University Libraries Department LIBR Digital Research Srvs & Collec Advertised Salary Range Commensurate with Experience Location of Vacancy Part/Full Time Full Time Hours per Week 37.5 Position Category Full-time Equivalent (FTE) Basis 12 months Work County Richland Tenure Information Tenure-Track/Tenured Job Search Category Faculty About USC About University of South Carolina From the Upstate to the Lowcountry, the University of South Carolina system is transforming the lives of South Carolinians through the impact of our eight institutions and 20 locations throughout the state. More than 50,000 students are enrolled at one of eight institutions, including the research campus in Columbia and comprehensive four-year universities in Aiken, Upstate and Beaufort. In addition, our Palmetto College campuses in Salkehatchie, Union, Lancaster and Sumter enable students to earn associate or bachelor’s degrees through a combination of in-person, online or blended learning. All of our system institutions place strong emphasis on service — helping to build healthier, more educated communities in South Carolina and beyond. Benefits for FTE Positions The University of South Carolina (USC), through the State of SC and Public Employee Benefit Authority (PEBA), offers state employees a valuable benefits package, including health and life insurance, generous paid leave and retirement programs. To learn more about USC benefits, access the "Working at USC" section on the Applicant Portal at https://uscjobs.sc.edu. Position Description Advertised Job Summary University of South Carolina Libraries is seeking an innovative and user-focused Research Impact librarian who will work in a collaborative environment to support the research needs of faculty across the university. The Research Impact Librarian strengthens the USC research enterprise by building knowledge of and fluency with advanced bibliometrics and research impact analyses. This person will develop and promote a suite of services supporting faculty and students’ research impact. The Librarian provides consultation and training for faculty, administrators, and students to elevate researcher profiles in scholarly platforms and optimize the dissemination and publication of scholarly works. Training topics would cover research impact concepts, bibliometrics approaches, citation analysis, finding data sources, and developing researcher profiles. The Librarian also supports programs designed to monitor attribution of USC-produced research in bibliometric data sources and supports researcher disambiguation to attribute USC authorship correctly. The librarian works with large data sets to analyze research metrics data in support of requests for research impact reporting and supports grant reporting requirements around impact metrics. The position complements our research support service areas within the Libraries. Required Education and Experience Required Education and Experience: MLIS from an ALA-accredited program (or equivalent); another graduate degree and relevant experience will be given equal consideration Experience providing research analytics support services Experience working with research metric data sources (e.g., Web of Science, Scopus, Google Scholar) Demonstrated knowledge of emerging trends in research impact and assessment. Demonstrated experience supporting library resources or tools Required Knowledge, Skills, and Abilities/Competencies: Ability to communicate effectively with users at all levels of expertise across disciplines Projects an approachable and customer service-oriented attitude Ability to collaborate effectively and work on teams Ability to effectively and efficiently learn new resources Knowledge of statistics and/or data science Preferred Qualifications Preferred Qualifications: Second master’s or PhD in a STEM or other data-dependent field 2+ years’ experience working in research libraries Experience and/or training in conducting systematic reviews Experience with data visualization and data analysis Knowledge of Python and R Demonstrated involvement in professional activities, including evidence of ability to contribute to librarianship, research, and service as well as capacity for leadership within the profession. Experience in developing and producing workshops and tutorials Posting Detail Information Desired Start Date 08/18/2025 Job Open Date 07/14/2025 Job Close Date 07/29/2025 Open Until Filled No Special Instructions to Applicant Positions are advertised for a minimum of five (5) business days on our job website. After five (5) business days, positions can be closed at the discretion of the department at any time. This employment site is updated on a regular basis. The length of the recruitment and screening process may vary from position to position, depending upon a variety of factors. Should review of your qualifications result in a decision to pursue your candidacy, you will be contacted by phone or email. Quicklink for Posting https://uscjobs.sc.edu/postings/190819 EEO Statement The University of South Carolina does not discriminate in educational or employment opportunities or decisions for qualified persons on the basis of age, ancestry, citizenship status, color, disability, ethnicity, familial status, gender (including transgender), gender identity or expression, genetic information, HIV/AIDs status, military status, national origin, pregnancy (false pregnancy, termination of pregnancy, childbirth, recovery therefrom or related medical conditions, breastfeeding), race, religion (including religious dress and grooming practices), sex, sexual orientation, veteran status, or any other bases under federal, state, local law, or regulations.

Posted 1 month ago

Mainstay Senior Living

Director of Nursing- LPN- Weekly Pay!

Columbia, SC 29206

*About Us* We are a warm, resident-centered assisted living and memory care community committed to providing compassionate care and enriching the lives of our seniors. We are currently seeking a dedicated and experienced *Director of Nursing (RN or LPN)* to lead our *Resident Services Department in* Assisted Living and Memory Care with professionalism, accountability, and a strong focus on people and leadership skills. *Job Summary* As Director of Nursing, you will oversee all aspects of resident care and wellness services. You’ll supervise a skilled team of nurses and caregivers, ensure compliance with healthcare regulations, and maintain a safe, supportive environment where residents can thrive. This role requires hands-on leadership, exceptional communication skills, and a deep understanding of the assisted living model. *Responsibilities* * Manage daily operations of the Resident Services Department * Supervise, train, and schedule nursing and care staff * Coordinate physician visits, medication administration, and wellness checks * Develop and maintain individualized care plans * Monitor resident conditions and respond to emergencies promptly * Ensure compliance with state and federal assisted living regulations * Conduct staff performance evaluations and support ongoing development * Lead admission, discharge, and care transition processes * Communicate effectively with residents, families, staff, and healthcare providers * Participate in inspections, audits, and regulatory surveys * Promote a respectful, inclusive, and accountable workplace culture *Qualifications* *Required:* * Current *RN or LPN license* in the state of [Insert State] * Graduate of an accredited nursing program * *CPR certification* * Minimum *3 years of experience in assisted living.* * At least *2 years in a supervisory or leadership role* * Proficient in care planning, assessments, and healthcare compliance *Preferred:* * Additional training in nursing leadership, geriatrics, or healthcare management * Prior experience in a healthcare management role within an assisted living community *Key Skills* * Strong leadership and team-building skills * Excellent interpersonal and communication abilities * Compassionate, resident-first approach to care * Strong time management and organizational skills * Proficient in Microsoft Office and electronic health records * High ethical standards and attention to confidentiality *Physical Requirements* * Ability to lift or carry up to 25 lbs * Regular walking, standing, and physical activity throughout the day *Work Environment* This role is located in a licensed assisted living facility and may involve exposure to infectious diseases. All safety precautions and PPE guidelines are strictly followed to ensure a safe working environment. *Why Join Us?* * Supportive leadership and collaborative team culture * Opportunities for professional development and career growth * Make a meaningful impact on the lives of seniors every day *Apply today* to join a compassionate team dedicated to delivering high-quality care and leadership in assisted living. Job Type: Full-time Pay: From $68,000.00 per year Benefits: * Dental insurance * Health insurance * Paid time off * Vision insurance Work Location: In person

Posted 1 month ago

System Procurement Manager I

Richland County, SC

Job Responsibilities Processes requisitions utilizing all procurement sourcing methods in compliance with the SC Consolidated Procurement Code, SC Regulations, and University departmental policies and procedures. Solicits, evaluates, and awards offerors for simple and complex purchases to include goods and services, professional services and construction related projects. Performs systemwide duties related to the procurement of complex construction projects for the University System. Collaborates with Design and Construction Project Managers and Office of the State Engineer when necessary and in accordance with State and University procurement related policies, rules, and regulations. Advertised Salary: $54,165 - Salary commensurate with qualifications Minimum and Additional Requirements Requires a bachelor’s degree in a job related field and 2 or more years of job related experience, which may be substituted by an equivalent combination of job related certification, training, education, and/or experience. Preferred Qualifications Universal Public Procurement Certification Council (UPPCC), CPPO or CPPB. NIGP-CPP is preferred. Additional Comments A knowledge of State and University policy and procedures. Familiarization with SC Consolidated Procurement Code and an interest in construction procurement. Knowledge of state procurement and/or professional services. Capable of working harmoniously with a diverse group of people. Must possess excellent written and oral communication skills. Good analytical and decision making skills. EEO Statement: The University of South Carolina does not discriminate in educational or employment opportunities or decisions for qualified persons on the basis of age, ancestry, citizenship status, color, disability, ethnicity, familial status, gender (including transgender), gender identity or expression, genetic information, HIV/AIDs status, military status, national origin, pregnancy (false pregnancy, termination of pregnancy, childbirth, recovery therefrom or related medical conditions, breastfeeding), race, religion (including religious dress and grooming practices), sex, sexual orientation, veteran status, or any other bases under federal, state, local law, or regulations.

Posted 1 month ago