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Specialist, Appeals at CGS - ApplyBlast

Specialist, Appeals

CGS

5 months ago

3.5 on Glassdoor

Nashville, Tennessee

Hybrid

Full Time

Junior

0 applicants

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About this role

An Appeals Specialist at CGS, a subsidiary of BlueCross BlueShield of South Carolina, performs non-medical reviews and processes redetermination letters for healthcare cases. This hybrid role involves analyzing comprehensive documentation, ensuring timely processing, and making decisions that directly impact patient healthcare outcomes.

Responsibilities

Review and process non-medical appeals and redetermination letters
Analyze comprehensive documentation for missing information
Ensure timely processing of healthcare appeal decisions
Update department letters and documents as necessary
Prepare documentation for legal inquiries and administrative requests

Skills

Qualifications

High School Diploma

About CGS

cgsadmin.com

Headquarters

Eşfahān, Isfahan, Iran

Company Size

11-50 employees

Founded

2011

View Profile

CGS Administrators, LLC, a Celerian Group company, provides healthcare administrative outsourcing and technology-enabled solutions for CMS programs. Their offerings include provider services, member services, and functional services designed to streamline health plan operations, reduce costs, and prevent fraud, with core activities in claims processing, credentialing, education, analytics, and program management. Headquartered in Nashville, Tennessee, CGS has supported millions of Medicare beneficiaries and thousands of providers for more than 50 years.