Appeals & Redetermination Specialist (Hybrid)
CGS Administrators
CGS Administrators is seeking an Appeals Specialist in Nashville, TN. This hybrid position involves reviewing non-medical redetermination letters, analyzing documentation, and ensuring timely healthcare decisions. The ideal candidate will have at least 2 years of related experience, excels in communication and organizational skills, and is proficient in Microsoft Office. Benefits include a 401(k) plan, subsidized health plans, and paid leave. Join a company dedicated to patient advocacy and healthcare outcomes. #J-18808-Ljbffr
- ...SummaryPerforms non-medical reviews and processes redetermination letters.DescriptionLogistics: CGS –one... ...companies.Location : This position is hybrid schedule 3 days onsite reporting at 26... ...(40 hours/week) Monday-Friday.As an Appeals Specialist, you'll be at the forefront of patient...SuggestedFull timeContract workFor contractorsWork experience placementSecond jobWork at officeLocal areaRemote workMonday to Friday
$48.68k
...Executive Service APPEALS RESOLUTION SPECIALISTDivision of... ...providing our employees with a hybrid work environment. All... ...seeking an Appeals Resolution Specialist for the Appeals Operations Group... ...action taken from a members redetermination process. Ability to...SuggestedWork experience placementWork at officeWork from home- CGS Administrators LLC is hiring an Appeals Specialist in Nashville, TN. The role involves performing non-medical reviews, processing redetermination letters, and preparing documentation for legal inquiries. Candidates should have a High School Diploma and 2 years of relevant...SuggestedRemote jobWork at office
- Join BlueCross BlueShield of South Carolina as an Appeals Specialist and engage in non-medical reviews and processing redetermination letters. This role offers flexibility with fully remote options and a supportive team environment. Candidates should have a High School...SuggestedRemote jobSecond jobWork at office
- BlueCross BlueShield of South Carolina is seeking an Appeals Specialist based in Nashville, TN, for a role that includes performing non-medical reviews and processing redetermination letters. This position offers the flexibility to work remotely, ensuring accurate documentation...SuggestedRemote jobWork at office
- ...seeking an Enrollment Contractor in Nashville, TN for a 12+ month hybrid contract. The contractor will assist the enrollment team with... ...with renewed Medicaid processes, and facilitating the redetermination process. Ideal candidates should have a degree and excellent...Contract workFor contractors
- Summary We are currently hiring for an Appeals Specialist to join BlueCross BlueShield of South Carolina. In this role as Appeals Specialist... ...be required to perform non‑medical reviews and process redetermination letters. Why Join Us BlueCross BlueShield of South...Full timeContract workFor contractorsWork experience placementSecond jobCurrently hiringWork at officeLocal areaRemote workShift work
- ...employment.What You’ll Do:Performs non-medical reviews and processes redetermination letters ensuring timeliness and accuracy.Prepares unit... ...Have the Following:Experience in medical claims processing, appeals, or coding strongly preferredMedicare Part B experience preferredStrong...Full timeContract workFor contractorsWork experience placementSecond jobWork at officeLocal areaRemote workShift work
- ...Reference Number: R1050717 We are currently hiring for an Appeals Specialist to join BlueCross BlueShield of South Carolina. In this role... ...candidate will perform non‑medical reviews and process redetermination letters. BlueCross BlueShield of South Carolina is a prominent...Full timeContract workFor contractorsWork experience placementCurrently hiringWork at officeLocal areaRemote workShift work
- ...TN. This role involves serving as a subject-matter expert in unemployment law and providing consultation to clients throughout the appeals process. The ideal candidate should have a college degree or equivalent experience, along with 2+ years in unemployment work. The position...
- ...BCMason Group in Nashville, TN seeks an Accounts Payable / Accounts Receivable Specialist to manage the full cycle of payables and receivables. This hybrid position requires 2-3 days in the office. Candidates should have 3+ years of experience in construction accounting...Work at office
- ...effective communication skills. Responsibilities include researching catalog information and ensuring accurate licensing claims. This hybrid role necessitates commuting to the Nashville office at least three days a week. Work within a diverse and inclusive environment is...Work at office3 days per week
- ...Prospect Infosys Inc in Nashville, TN is seeking a Managed Care Specialist for a hybrid role. The candidate will determine eligibility for care programs, conduct interviews, and manage legal casework documentation. Essential qualifications include a degree, strong communication...Contract workRemote work
- ...TeamHealth is seeking a Senior Accounts Receivable Representative for a hybrid position in Louisville, TN. The role involves maintaining accuracy and production standards in the Accounts Receivable department, overseeing daily activities, and training associates. Ideal...
- ...Radiologist to join their collegial team. This position offers competitive salary with incentives, generous PTO, and potential for hybrid work. The role involves state-of-the-art cardiac imaging technology and opportunities for faculty appointment. Located in Nashville...Remote work
- A leading staffing agency is seeking a Senior Specialist in Accounts Payable for a hybrid 6+ month contract in Brentwood, TN. The ideal candidate will have over 3 years' experience in a high-volume AP department, be familiar with SAP, and possess strong research and resolution...Contract work
- ...FHIR Interoperability Specialist Nashville, TN/Hybrid 4+ Months Job Overview: The Tennessee Department of Health (TDH) Office of Informatics and Analytics (OIA), Core Informatics unit is currently recruiting a FHIR Interoperability Specialist to coordinate...Work at officeRemote work
- ...Zander Insurance Agency in Nashville is seeking an Identity Theft Specialist to join their dynamic team. This role is pivotal in assisting... ...-leading compensation, 100% employer-paid insurance, and a hybrid work schedule. If you’re passionate about protecting families and...
- A music industry service organization in Nashville seeks a dedicated customer experience representative. This full-time, hybrid role involves building strong customer relationships and providing exceptional service across various channels. Ideal candidates have a year...Full time
- Schneider Electric is hiring an Export Jurisdiction & Classification Specialist in Raleigh, NC, with a hybrid working environment. This role involves determining export control classifications for products and technology, collaborating across teams to integrate export...
$120k
...at least 3 years of experience in high-stakes environments, demonstrating emotional intelligence and excellent communication skills. A hybrid work environment is offered, along with performance incentives that can exceed $120,000. #J-18808-Ljbffr Andrew C Beasley PLLCFull time- ...The ideal candidate will enjoy researching and communicating technical issues to assist home buyers. This full-time position offers hybrid work flexibility, a supportive culture, and opportunities for professional development. Benefits include a health insurance stipend...Full time
$5,100 - $6,373 per month
...The State of Tennessee is seeking a TDOT Technical Specialist in Nashville to support the implementation of drone and Advanced Air Mobility (AAM) projects. This hybrid position involves project coordination, stakeholder engagement, and compliance with FAA regulations....$48.68k - $73.19k
...disabilities. Candidates must possess a bachelor's degree and have relevant experience with disabilities or mental health. The role offers a hybrid working model located in Jackson, TN, with a competitive salary ranging from $48,684 to $73,188 annually. #J-18808-Ljbffr State of...Full time- Protect Environmental is looking for an End Point Technical Specialist to manage the deployment, maintenance, and administration of desktop... ...expertise in troubleshooting and user access management in a hybrid environment. A Bachelor's degree and three years of relevant experience...
- ...HealthIT Customer Care Team A**Job Summary:**The EMR Adoption Specialists implements new systems and updates to current systems with occasional... ...and clinician onboarding. (Note: This role is a local / hybrid role, supporting Nashville and all surrounding facilities and...Work at officeLocal areaFlexible hours
- ...Tennessee is seeking a Historic Preservation Senior Technical Specialist to support the Cultural Resources Unit. This role will work both... ...providing technical expertise for TDOT projects. The position offers a hybrid work model with three days in the office and two days remote...Work at officeRemote work
- ...setting up tracking on websites, producing reports, and analyzing web data to enhance marketing strategies. MODEA offers a flexible work environment with options for fully remote or hybrid work, promoting diversity and inclusion in the workplace. #J-18808-Ljbffr MODEARemote jobFlexible hours
- ...), Core Informatics unit is recruiting a FHIR Interoperability Specialist to coordinate and support public health FHIR interoperability activities... ...Location FHIR Interoperability Specialist — Nashville, TN / Hybrid • 4+ Months Responsibilities Contribute significantly to...Work at officeRemote work
- ...staffing solutions provider is seeking an Accounts Receivable Specialist for a contract-to-hire opportunity in Brentwood, TN. The role involves... ...to handle high-volume transactions. The position offers a hybrid work model after 90 days of onsite training. #J-18808-Ljbffr...Contract work
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