BlueCross BlueShield of Tennessee

The role involves assisting non-clinical staff with administrative reviews and initiating referrals to coordinate appropriate care, while also seeking Medical Director advice when necessary according to policy. Responsibilities include performing comprehensive provider and member appeals, denial interpretation, retrospective claim reviews, and Utilization Management pre-certifications and appeals using clinical judgment and appropriateness criteria.

Coding Auditor conducting claims payment reviews and coding compliance audits

Are you driven by precision and committed to maintaining excellence in clinical coding? The Professional and Ancillary Audit Department at BCBST is seeking a skilled Coding Auditor to join our team in conducting comprehensive claims payment quality reviews and clinical coding com...

Medical Record Scheduling & Imaging Technician handling medical records at BCBST

Our Claims Payment Integrity team is seeking a Director to lead critical work that strengthens payment accuracy and drives meaningful affordability results for our members. In this role, you will have the opportunity to work with high-performing internal teams and vendor partners...

The BlueCard ITS Applications team is seeking an experienced Software Engineer! In this role, you will support critical BlueCard claims processing by maintaining and enhancing internal‑facing applications while helping modernize legacy systems. Work with a variety of technologies...

Software Engineer developing Salesforce solutions for BCBST

Associate Software Engineer II handling tasks for Salesforce Health Cloud and Marketing Cloud

Field Sales Representative connecting brokers, consultants, and internal partners at BCBST

Associate MLOps Engineer supporting machine learning solutions at BlueCross BlueShield