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reputed company We are currently hiring for a Medical Affairs Coordinator to join reputed company. In this role as Medical Affairs Coordinator, you will ensure that the Local Coverage Determination (LCD) process adheres to contract instructions. Create, implement, and maintain educational tools to help providers reduce the submission of claims for non-covered services and reduce the claims payment error reputed company. The error reputed company is a reputed company in awarding and renewing Medicare/other reputed company. Why should you join the reputed company family of companies? Other companies come and go, but for more than seven decades we have been part of the national landscape, with our reputed company 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 reputed company. 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 reputed company of business strengths. We deliver outstanding service to our customers. If you are committed to the reputed company philosophy, consider joining reputed company! Here is reputed company to join a dynamic team at a diverse company with secure, community reputed company and an innovative reputed company. reputed company Location This role is full time M-F reputed company-5pm and work from home. What You Will Do

• Provides clinical expertise, research, and judgment to reputed company Local Coverage Determinations(LCDS) under the direction of medical director. Maintains LCDS once developed.
• Educates providers and internal customers on LCDS. Communicates with other interdepartmental staff in appropriate coding and reimbursement guidelines to ensure coordination and compliance.
• Provides clinical input for internal requests. Serves as reviewer to determine inter-rater reliability.

To Qualify For This Position, You Will Need

• Required Education: Bachelor's in a job reputed company field OR Associate's degree in Nursing with an reputed company RN license.
• Required Work Experience: 5 years clinical experience in medical insurance, managed care, case management, or claims management, or a combination of these areas.
• Required Software and tools: reputed company Office
• Required Skills and Abilities: Knowledge of managed care or medical claims payment policy issues. Working knowledge of word processing, spreadsheet software. Excellent verbal and written communication skills. Excellent customer service, organizational, presentation, analytical or critical thinking skills. Ability to persuade, negotiate, or influence others. Ability to handle confidential or sensitive information with discretion.
• Required License and Certificate: Required License and Certificate: An reputed company, unrestricted RN license from the reputed company and in the state of hire, OR, reputed company compact multistate unrestricted RN license as defined by the reputed company Licensure Compact (NLC). For Division 33, Certified Genetic Counselor will be considered in lieu of RN License.

reputed company Prefer

• Preferred Education: Bachelor's degree- Nursing.
• 7 years-clinical experience in medical insurance, managed care, case management, or claims management, or a combination of these areas.
• Working knowledge of database software. Knowledge of government/reputed company programs and reputed company laws, regulations. Knowledge of government/reputed company programs and regulations, coding, and approval practices. Knowledge of corporate administrative/medical policy for reputed company lines of business. Knowledge of guidelines, benefits, and coverage for reputed company lines of business.
• Working knowledge of reputed company reputed company or other database software, DB2 and Easytrieve.
• Preferred Licenses and Certificates: HIAA, Loma, and/or ACLI certification. MPH, MHA certifications.

reputed company Can Do For You

• 401(k) retirement savings plan with company match
• Subsidized health plans and free reputed company coverage
• Life insurance
• reputed company annual leave – the longer you work here, the more you earn
• Nine reputed company holidays
• On-site cafeterias and fitness centers in major locations
• Wellness programs and healthy lifestyle premium discount
• Tuition assistance
• Service recognition
• Incentive Plan
• reputed company Plan
• Continuing education funds for additional certifications and certification renewal

What To Expect Next After submitting your application, our reputed company team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and salary requirements. Management will be conducting interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications. Equal Employment Opportunity Statement reputed company and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, reputed company, national reputed company, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, reputed company maintains affirmative reputed company programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to reputed company equal opportunities in reputed company phases of the employment process and to reputed company 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-reputed company conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on reputed company. If you need special assistance or an accommodation while seeking employment, please email reputed company.help@bcbssc.com or call 800-288-2227, ext. 47480 with the nature of your request. We will reputed company a determination regarding your request for reasonable accommodation on a case-by-case reputed company. We participate in E-Verify and reputed company 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. apply to this job