BlueCross BlueShield of Tennessee

Bringing peace of mind through better health to our customers and communities

Senior Appeals and Grievance Analyst

AnalystAnalystOther Remote SeniorTeam 5,001-10,000Since 1952H1B SponsorCompany Site LinkedIn

Location

Tennessee

Posted

15 days ago

Salary

Not specified

Seniority

Senior

Associate Degree3 yrs expEnglish

Job Description

• Reviewing and processing appeals and grievances submitted by Members and Providers • Documenting and investigating the substance of the appeal, grievance, or complaint • Notifying involved parties of the outcome of a review • Providing excellent customer services to members, providers and CMS • Maintaining knowledge of and adhering to CMS regulations and guidelines

Job Requirements

Associates degree or equivalent work experience required
2 years - Customer service and/or claims experience
1 year – Medicare Advantage customer service and claims experience required
Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
Proficient oral and written communication skills
Proficient interpersonal and organizational skills
Ability to work independently
Capacity to solve problems and manage multiple assignments with critical deadlines
Knowledge of CMS regulations and guidelines related to appeals, grievances and complaints