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Results based on filters ( 9 jobs found )

Customer Service Advocate II

CGS Administrators LLC
Kentucky
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CGS Administrators LLC United States, Kentucky May 05, 2026 Summary Provides ...
Details
Summary
About the job:
prompt, accurate, thorough and courteous responses to all customer inquiries. Inquiries may be non-routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Description 60% Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, or walk-in inquiries. Handles situations which may require adaptation of response or extensive research. Accurately documents inquiries. 15% Initiates or processes...
Location:
Kentucky
Job Type:
Full-Time
Permanent
Occupation:
Customer Service Representatives
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
From:
Diversityjobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Job Posting Title RN Appeals Analyst (W@H TN)

CGS Administrators, LLC
Located in Ohio
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Summary We are currently hiring for a RN Appeals Analyst to join BlueCross ...
Details
Summary
About the job:
BlueShield of South Carolina. In this role as a RN Appeals Analyst, you will research 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 decisions within mandated timeframes and in compliance with applicable regulations or standards. Description Logistics: CGS –one of BlueCross BlueShield's South Carolina...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Himalayas
Certifications / Licenses:
National Committee for Quality Assurance
Certified Registered Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Auditor III

CGS Administrators, LLC
Grove City, OH
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86684936 293349561 Internal Reference Number: R1049924 Summary Responsible ...
Details
Summary
About the job:
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 The Auditor position is a full-time (40 hours) remote position with a flexible schedule that can include working 4 days per week. This position has the ability to work from any US location. What You'll Do: Conducts internal and/or external timely operational, financial, and/or compliance audits of divisions,...
Location:
Grove City, OH
Job Type:
Full-Time
Permanent
Occupation:
Accountants and Auditors
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
OhioMeansJobs.com
Certifications / Licenses:
Certified Internal Auditor
Certified Public Accountant
Certified Information Systems Auditor
Workkeys
Applied Math
5
Graphic Literacy
5
Workplace Documents
6
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Detailed Job Information

Auditor, Sr Stoploss Claim

CGS Administrators, LLC
Grove City, OH
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86554812 293282365 Internal Reference Number: R1049782 Summary Audit and ...
Details
Summary
About the job:
authorize reimbursement of specific medical stop loss claims. Effectively mitigate client medical stop loss claims and provide excellent customer service.Description Location: This position is full-time (40 hours/week) Monday-Friday from 8:00am-4:30pm CST and will be fully remote or hybrid if based near our Dallas office. What You'll Do: Analyze and adjudicate stop loss claims and request appropriate reimbursement from carrier. Recognize cost mitigation opportunities. Authorize and release stop loss claims reimbursement...
Location:
Grove City, OH
Job Type:
Full-Time
Permanent
Occupation:
Claims Adjusters, Examiners, and Investigators
Career Level / Education:
High school diploma or equivalent
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
OhioMeansJobs.com
Certifications / Licenses:
N/A
Workkeys
Applied Math
5
Graphic Literacy
5
Workplace Documents
6
apply
Detailed Job Information

Associate Medical Director DME

CGS Administrators, LLC
Grove City, OH
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85561226_1 293248940 Internal Reference Number: R1048061 Summary Why should ...
Details
Summary
About the job:
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...
Location:
Grove City, OH
Job Type:
Full-Time
Permanent
Occupation:
Compliance Officers
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
OhioMeansJobs.com
Certifications / Licenses:
Medical License
Security clearance
Workkeys
Applied Math
5
Graphic Literacy
5
Workplace Documents
5
apply
Detailed Job Information

Physical Medicine and Rehabilitation Medical Director

CGS Administrators, LLC
Grove City, OH
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86443015 293246478 Internal Reference Number: R1049672 Summary As member of ...
Details
Summary
About the job:
the senior management team, provides administrative oversight to the medical staff, analyzes medical review utilization data, researches new medical procedures or technology, and acts as a resource to providers and internal staff on issues concerning medical policies. May also write and revise medical policies.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 United States or...
Location:
Grove City, OH
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
OhioMeansJobs.com
Certifications / Licenses:
Board Certified
Medical License
Workkeys
Applied Math
5
Graphic Literacy
6
Workplace Documents
5
apply
Detailed Job Information

Medical Reviewer II (Prior-Auth A/B MAC) - CGS

CGS Administrators, LLC
Grove City, OH
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86416668 293239056 Internal Reference Number: R1049548 Summary Performs ...
Details
Summary
About the job:
medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices.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...
Location:
Grove City, OH
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
OhioMeansJobs.com
Certifications / Licenses:
Certified Registered Nurse
Licensed Practical Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Medicare Medical Director

CGS Administrators, LLC
Grove City, OH
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85617539 293210977 Internal Reference Number: R1048203 Summary Why should ...
Details
Summary
About the job:
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...
Location:
Grove City, OH
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
OhioMeansJobs.com
Certifications / Licenses:
Board Certified
Medical License
Workkeys
Applied Math
5
Graphic Literacy
5
Workplace Documents
5
apply
Detailed Job Information

Molecular Diagnostics Medicare Medical Director - Palmetto GBA

CGS Administrators, LLC
Grove City, OH
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86292650 293206722 Internal Reference Number: R1048417 Summary As member of ...
Details
Summary
About the job:
the senior management team, provides administrative oversight to the medical staff, analyzes medical review utilization data, researches new medical procedures or technology, and acts as a resource to providers and internal staff on issues concerning medical policies. May also write and revise medical policies.Description Location: This position is full-time (40-hours/week) Monday-Friday-Hourly). This position can be worked remotely. Position Purpose: The Molecular Diagnostics Medicare Medical Director at Palmetto GBA...
Location:
Grove City, OH
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
OhioMeansJobs.com
Certifications / Licenses:
Board Certified
Medical License
Workkeys
Applied Math
5
Graphic Literacy
5
Workplace Documents
5
apply
Detailed Job Information
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