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Results based on filters ( 17 jobs found )

Manager, Medical Review (Medicare - Appeals; Utilization Review; Part A; HHH)

CGS Administrators LLC
Myrtle Beach, SC
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CGS Administrators LLC life insurance, paid time off, 401(k) United States, ...
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About the job:
South Carolina, Myrtle Beach Apr 17, 2026 Summary Oversees 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. 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...
Location:
Myrtle Beach, SC
Job Type:
Full-Time
Permanent
Occupation:
Compliance Officers
Career Level / Education:
Bachelor's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Diversityjobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Manager, Medical Review (Medicare - Appeals; Utilization Review; Part A; HHH)

CGS Administrators LLC
Nashville, TN
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CGS Administrators LLC life insurance, paid time off, 401(k) United States, ...
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Summary
About the job:
Tennessee, Nashville Apr 17, 2026 Summary Oversees 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. 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...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Compliance Officers
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
Diversityjobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Auditor I

CGS Administrators LLC
Springfield, IL
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CGS Administrators LLC $20.84$29.59$38.33 life insurance, paid time off, ...
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401(k) United States, Illinois, Springfield 3021 Montvale Drive ( Show on map ) Apr 15, 2026 Summary Responsible 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 assigned portions of audit programs, determines compliance with policies and procedures, recommends corrective action plans, and prepares/submits...
Location:
Springfield, IL
Job Type:
Full-Time
Permanent
Occupation:
Accountants and Auditors
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
Diversityjobs
Certifications / Licenses:
Certified Information Systems Auditor
Certified Public Accountant
Certified Internal Auditor
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 ...
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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
apply
Detailed Job Information

Corporate Communications Writer - Onsite

CGS Administrators LLC
Nashville, TN
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CGS Administrators LLC life insurance, paid time off, 401(k) United States, ...
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Summary
About the job:
Tennessee, Nashville Apr 14, 2026 Summary Description 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 have 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...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Public Relations Specialists
Career Level / Education:
Bachelor's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Diversityjobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Accounting Technician III (Accounts Payable)

CGS Administrators LLC
Nashville, TN
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CGS Administrators LLC life insurance, paid time off, 401(k) United States, ...
Details
Summary
About the job:
Tennessee, Nashville Apr 10, 2026 Summary Description 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...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Bookkeeping, Accounting, and Auditing Clerks
Career Level / Education:
Some college, no degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Diversityjobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Technician, Data Preparation Senior

CGS Administrators, LLC
Located in Ohio
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Summary Performs advanced, varied clerical duties in accordance with ...
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Summary
About the job:
standard procedures. This includes clerical duties such as photocopying, compiling records, filing, tabulating, posting information, and distributing mail. Applies knowledge of department policies and procedures, and utilizes a general understanding of other departments' functions to resolve most issues. Maintains records, prepares forms, verifies information and resolves routine problems. May orient, train, assign and check the work of lower level employees and be designated as lead worker. Description Logistics: CGS...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Office Clerks, General
Career Level / Education:
High school diploma or equivalent
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Himalayas
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
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 ...
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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 ...
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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
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