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Clinical Review Manager at BlueCross BlueShield of Tennessee - ApplyBlast

Clinical Review Manager

BlueCross BlueShield of Tennessee

5 months ago

3.7 on Glassdoor

Chattanooga

Onsite

Full Time

Senior

0 applicants

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About this role

A Clinical Appeals Specialist at BCBST BlueCross BlueShield of Tennessee, Inc. coordinates care, reviews medical claims, and handles appeals for providers and members.

Responsibilities

Initiate referrals to ensure appropriate coordination of care
Perform comprehensive provider and member appeals and denial interpretation
Assist non-clinical staff in administrative reviews
Work independently and creatively
Manage multiple projects and priorities

Skills

Qualifications

Registered Nurse (RN) with active license in Tennessee or participating state3 years clinical experience

About BlueCross BlueShield of Tennessee

bcbst.com

Headquarters

Chattanooga, Tennessee, United States

Company Size

5001-10000 employees

Founded

1945

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Learn more about BlueCross BlueShield of Tennessee (BCBST) health insurance and the medical, dental and vision plans we offer for employers, individuals and families.