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Results based on filters ( 81 jobs found )

Molecular Diagnostics Medicare Medical Director - Palmetto GBA

CGS Administrators, LLC
Grove City, OH
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86292650 293206722 Internal Reference Number: R1048417 Summary As member of ...
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Summary
About the job:
the senior management team, provides administrative oversight to the medical staff, analyzes medical review utilization data, researches new medical procedures or technology, and acts as a resource to providers and internal staff on issues concerning medical policies. May also write and revise medical policies.Description Location: This position is full-time (40-hours/week) Monday-Friday-Hourly). This position can be worked remotely. Position Purpose: The Molecular Diagnostics Medicare Medical Director at Palmetto GBA...
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Workkeys
Applied Math
5
Graphic Literacy
5
Workplace Documents
5
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Mainframe Developer III- CGS Administrators, LLC (Nashville, TN)

CGS Administrators LLC
Nashville, TN
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CGS Administrators LLC life insurance, paid time off, paid holidays, tuition ...
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assistance, 401(k) United States, Tennessee, Nashville Feb 10, 2026 Summary Working at CGS Administrators CGS Administrators, LLC (CGS) is part of BCBSSC's Celerian Group of companies and provides a variety of services for Medicare beneficiaries, healthcare providers, and medical equipment suppliers in 38 states, supporting the needs of over 8.7 million Medicare beneficiaries and 103,000 healthcare professionals nationwide. We deliver outstanding service to our customers. If you are dedicated to the same philosophy,...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Software Developers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Diversityjobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
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Auditor I

CGS Administrators LLC
Nashville, TN
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CGS Administrators LLC $19.36$27.36$35.67 life insurance, paid time off, ...
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401(k) United States, Tennessee, Nashville Feb 10, 2026 Summary Responsible for assisting in the execution of financial, compliance, and operational audits including evaluation of internal controls. Audits the activity of various departments and providers for compliance with plans, policies, and procedures prescribed by management. Reviews assigned portions of audit programs, determines compliance with policies and procedures, recommends corrective action plans, and prepares/submits reports on the results of audits....
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Accountants and Auditors
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
Diversityjobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
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Auditor I

CGS Administrators LLC
Columbia, SC
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CGS Administrators LLC $19.36$27.36$35.67 life insurance, paid time off, ...
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401(k) United States, South Carolina, Columbia Feb 10, 2026 Summary Responsible for assisting in the execution of financial, compliance, and operational audits including evaluation of internal controls. Audits the activity of various departments and providers for compliance with plans, policies, and procedures prescribed by management. Reviews assigned portions of audit programs, determines compliance with policies and procedures, recommends corrective action plans, and prepares/submits reports on the results of audits....
Location:
Columbia, SC
Job Type:
Full-Time
Permanent
Occupation:
Accountants and Auditors
Career Level / Education:
Bachelor's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Diversityjobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
4
Graphic Literacy
5
Workplace Documents
4
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Detailed Job Information

Auditor I

CGS Administrators LLC
Springfield, IL
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CGS Administrators LLC $19.36$27.36$35.67 life insurance, paid time off, ...
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401(k) United States, Illinois, Springfield 3021 Montvale Drive ( Show on map ) Feb 10, 2026 Summary Responsible for assisting in the execution of financial, compliance, and operational audits including evaluation of internal controls. Audits the activity of various departments and providers for compliance with plans, policies, and procedures prescribed by management. Reviews assigned portions of audit programs, determines compliance with policies and procedures, recommends corrective action plans, and prepares/submits...
Location:
Springfield, IL
Job Type:
Full-Time
Permanent
Occupation:
Accountants and Auditors
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
Diversityjobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Application Development Manager- CGS Administrators, LLC (Nashville, TN)

CGS Administrators LLC
Nashville, TN
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CGS Administrators LLC life insurance, paid time off, paid holidays, tuition ...
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Summary
About the job:
assistance, 401(k) United States, Tennessee, Nashville Feb 10, 2026 Summary Working at CGS Administrators CGS Administrators, LLC (CGS) is part of BCBSSC's Celerian Group of companies and provides a variety of services for Medicare beneficiaries, healthcare providers, and medical equipment suppliers in 38 states, supporting the needs of over 8.7 million Medicare beneficiaries and 103,000 healthcare professionals nationwide. We deliver outstanding service to our customers. If you are dedicated to the same philosophy,...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Computer and Information Systems Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Diversityjobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Part A/HHH Appeals Specialist

CGS Administrators LLC
Nashville, TN
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CGS Administrators LLC life insurance, paid holidays, tuition assistance, ...
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401(k) United States, Tennessee, Nashville Feb 10, 2026 Summary Performs non-medical reviews and processes redetermination letters. Description CGS Administrators provides a variety of services, under contracts with the Centers for Medicare and Medicaid Services (CMS) for beneficiaries, health care providers, and medical equipment suppliers in 33 states, supporting the needs of more than 20 million Medicare beneficiaries nationwide. We deliver outstanding service to our customers. If you are dedicated to the same...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Billing and Posting Clerks
Career Level / Education:
High school diploma or equivalent
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Diversityjobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Job Posting Title RN Appeals Analyst (W@H TN)

CGS Administrators LLC
Tennessee
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CGS Administrators LLC life insurance, paid time off, 401(k) United States, ...
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About the job:
Tennessee Feb 10, 2026 Summary We are currently hiring for a RN Appeals Analyst to join BlueCross BlueShield of South Carolina. In this role as a RN Appeals Analyst, you will research the substance of complex appeal or retrospective review requests including pre-pay and post-payment review appeal requests. Provides thorough clinical review or benefit analysis to determine if the requested services meet medical necessity guidelines. Documents decisions within mandated timeframes and in compliance with applicable...
Location:
Tennessee
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
Diversityjobs
Certifications / Licenses:
National Committee for Quality Assurance
Certified Registered Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Job Posting Title RN Appeals Analyst Medicare Part B - CGS

CGS Administrators LLC
Tennessee
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CGS Administrators LLC life insurance, paid holidays, tuition assistance, ...
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Summary
About the job:
401(k) United States, Tennessee Feb 09, 2026 Summary We are currently hiring for an Appeals Analyst to join BlueCross BlueShield of South Carolina. In this role as Appeals Analyst, you will research the substance of complex appeal or retrospective review requests including pre-pay and post-payment review appeal requests. Additionally, you will provide thorough clinical review or benefit analysis to determine if the requested services meet medical necessity guidelines. Lastly, you will document decisions within mandated...
Location:
Tennessee
Job Type:
Full-Time
Permanent
Occupation:
Healthcare Social Workers
Career Level / Education:
Master's degree
Salary:
High Income Jobs ($80K-$99K)
From:
Diversityjobs
Certifications / Licenses:
Sex Therapist Certification
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Provider Enrollment Analyst

CGS Administrators LLC
Nashville, TN
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CGS Administrators LLC life insurance, paid time off, 401(k) United States, ...
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About the job:
Tennessee, Nashville Feb 09, 2026 Summary Responsible in the provider enrollment process to review, research, analyze, and process provider enrollment applications. Ensures provider file integrity and that suppliers are in compliance with established standards and guidelines. Description Logistics: CGS (cgsadmin.com) - one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Computer User Support Specialists
Career Level / Education:
Some college, no degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Diversityjobs
Certifications / Licenses:
Security clearance
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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