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Results based on filters ( 34 jobs found )

Appeals Analyst Medicare Part B - CGS

CGS Administrators LLC
Nashville, TN
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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, Nashville 2 Vantage Way ( Show on map ) Dec 06, 2025 Summary Researches 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 regulations or standards. Description Logistics CGS-one of BlueCross BlueShield's South...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Diversityjobs
Certifications / Licenses:
Certified Registered Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Appeals Analyst Medicare Part B - CGS

CGS Administrators LLC
South Carolina
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CGS Administrators LLC life insurance, paid holidays, tuition assistance, ...
Details
Summary
About the job:
401(k) United States, South Carolina Dec 06, 2025 Summary Researches 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 regulations or standards. Description Logistics CGS-one of BlueCross BlueShield's South Carolina subsidiary companies. This...
Location:
South Carolina
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
Diversityjobs
Certifications / Licenses:
Certified Registered Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Appeals Analyst Medicare Part B - CGS

CGS Administrators LLC
Tennessee
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CGS Administrators LLC life insurance, paid holidays, tuition assistance, ...
Details
Summary
About the job:
401(k) United States, Tennessee Dec 06, 2025 Summary Researches 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 regulations or standards. Description Logistics CGS-one of BlueCross BlueShield's South Carolina subsidiary companies. This...
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:
Certified Registered Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Appeals Analyst Medicare Part B - CGS

CGS Administrators LLC
Alabama
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CGS Administrators LLC life insurance, paid holidays, tuition assistance, ...
Details
Summary
About the job:
401(k) United States, Alabama Dec 06, 2025 Summary Researches 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 regulations or standards. Description Logistics CGS-one of BlueCross BlueShield's South Carolina subsidiary companies. This...
Location:
Alabama
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
Diversityjobs
Certifications / Licenses:
Certified Registered Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Medical Review Director - CGS Administrators, LLC

CGS Administrators LLC
Columbia, SC
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CGS Administrators LLC life insurance, paid time off, 401(k) United States, ...
Details
Summary
About the job:
South Carolina, Columbia Dec 05, 2025 Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we've been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the...
Location:
Columbia, SC
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Diversityjobs
Certifications / Licenses:
Security clearance
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Medical Review Director - CGS Administrators, LLC

CGS Administrators LLC
Nashville, TN
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CGS Administrators LLC life insurance, paid time off, 401(k) United States, ...
Details
Summary
About the job:
Tennessee, Nashville 2 Vantage Way ( Show on map ) Dec 05, 2025 Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we've been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Diversityjobs
Certifications / Licenses:
Security clearance
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Medical Review Director - CGS Administrators, LLC

CGS Administrators LLC
Springfield, IL
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CGS Administrators LLC life insurance, paid time off, 401(k) United States, ...
Details
Summary
About the job:
Illinois, Springfield 3021 Montvale Drive ( Show on map ) Dec 05, 2025 Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we've been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated...
Location:
Springfield, IL
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Diversityjobs
Certifications / Licenses:
Security clearance
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Technician, Data Preparation Senior

CGS Administrators LLC
Nashville, TN
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CGS Administrators LLC life insurance, paid time off, 401(k) United States, ...
Details
Summary
About the job:
Tennessee, Nashville 2 Vantage Way ( Show on map ) Dec 05, 2025 Summary Performs advanced, varied clerical duties in accordance with standard procedures. This includes clerical duties such as photocopying, compiling records, filing, tabulating, posting information, and distributing mail. Applies knowledge of department policies and procedures, and utilizes a general understanding of other departments' functions to resolve most issues. Maintains records, prepares forms, verifies information and resolves routine...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Office Clerks, General
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
From:
Diversityjobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Senior Provider Relations Representative - CGS

CGS Administrators LLC
Tennessee
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CGS Administrators LLC life insurance, paid time off, 401(k) United States, ...
Details
Summary
About the job:
Tennessee Dec 05, 2025 Summary As a member of the DMEPOS (Durable Medical Equipment Prosthetics, Orthotics and Supplies) team you will provide education and training for network providers, staff, suppliers, physicians, beneficiaries, and referral agents as necessary. You will develop and produce all training and educational materials for virtual and onsite training classes. Description Logistics: CGS (cgsadmin.com) - one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This is a hybrid...
Location:
Tennessee
Job Type:
Full-Time
Permanent
Occupation:
Training and Development Specialists
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
Diversityjobs
Certifications / Licenses:
Security clearance
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Consultant, Sr Provider Education

CGS Administrators LLC
Nashville, TN
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CGS Administrators LLC life insurance, paid time off, 401(k) United States, ...
Details
Summary
About the job:
Tennessee, Nashville 2 Vantage Way ( Show on map ) Dec 03, 2025 Summary Provides education to medical providers as warranted. Description Logistics: CGS (cgsadmin.com) - one of BlueCross BlueShield's South Carolina subsidiary companies. Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. Location: This a hybrid position. Onsite work will be performed at 26 Century Blvd. Nashville, TN 37214. You will work an 8-hour shift scheduled...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Licensed Practical and Licensed Vocational Nurses
Career Level / Education:
Postsecondary nondegree award
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Diversityjobs
Certifications / Licenses:
Security clearance
Licensed Practical Nurse
Certified Registered Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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