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IT Business Systems Analyst II (Medicare/Medicaid)- CGS Administrators, LLC (Nashville, TN)

CGS Administrators, LLC
Nashville, TN
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Summary Working at CGS Administrators CGS Administrators, LLC (CGS) is part ...
Details
Summary
About the job:
of BCBSSC&trade'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. This is an onsite full-time position located at 26 Century Blvd., Ste. ST610 Nashville, TN 37214-3685. If you have IT Business Analysis Healthcare experience and leadership capabilities, this could be the perfect role for you. Join a...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Project Management Specialists
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Diversity.com
Certifications / Licenses:
Certified Business Analysis Professional
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
Located in Ohio
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Summary We are currently hiring for a RN Appeals Analyst to join BlueCross ...
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Summary
About the job:
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 regulations or standards. Description Logistics: CGS –one of BlueCross BlueShield's South Carolina...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Himalayas
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

Manager, Medical Review (Medicare - Appeals; Utilization Review; Part A; HHH)

CGS Administrators LLC
Myrtle Beach, SC
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CGS Administrators LLC life insurance, paid time off, 401(k) United States, ...
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About the job:
South Carolina, Myrtle Beach Apr 17, 2026 Summary Oversees the accurate processing of claims that have been deferred for medical necessity review. Ensures compliance with nationally recognized standards, and local, state, and federal laws and regulations. Identifies and implements process improvement opportunities. Description Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with...
Location:
Myrtle Beach, SC
Job Type:
Full-Time
Permanent
Occupation:
Compliance Officers
Career Level / Education:
Bachelor's degree
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

Manager, Medical Review (Medicare - Appeals; Utilization Review; Part A; HHH)

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 Apr 17, 2026 Summary Oversees the accurate processing of claims that have been deferred for medical necessity review. Ensures compliance with nationally recognized standards, and local, state, and federal laws and regulations. Identifies and implements process improvement opportunities. Description Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Compliance Officers
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

Auditor I

CGS Administrators LLC
Springfield, IL
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CGS Administrators LLC $20.84$29.59$38.33 life insurance, paid time off, ...
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401(k) United States, Illinois, Springfield 3021 Montvale Drive ( Show on map ) Apr 15, 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:
Certified Information Systems Auditor
Certified Public Accountant
Certified Internal Auditor
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Auditor III

CGS Administrators, LLC
Grove City, OH
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86684936 293349561 Internal Reference Number: R1049924 Summary Responsible ...
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About the job:
for providing a full range of financial, compliance, and operational audits, business advisory, and consultation services, investigations, internal controls, accountability, and use of resources. Description The Auditor position is a full-time (40 hours) remote position with a flexible schedule that can include working 4 days per week. This position has the ability to work from any US location. What You'll Do: Conducts internal and/or external timely operational, financial, and/or compliance audits of divisions,...
Location:
Grove City, OH
Job Type:
Full-Time
Permanent
Occupation:
Accountants and Auditors
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
OhioMeansJobs.com
Certifications / Licenses:
Certified Internal Auditor
Certified Public Accountant
Certified Information Systems Auditor
Workkeys
Applied Math
5
Graphic Literacy
5
Workplace Documents
6
apply
Detailed Job Information

Corporate Communications Writer - Onsite

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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Summary
About the job:
Tennessee, Nashville Apr 14, 2026 Summary Description 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 have 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...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Public Relations Specialists
Career Level / Education:
Bachelor's degree
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

Accounting Technician III (Accounts Payable)

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 Apr 10, 2026 Summary Description 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...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Bookkeeping, Accounting, and Auditing Clerks
Career Level / Education:
Some college, no degree
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

Processor, Claims II

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 Apr 09, 2026 Summary Reviews and adjudicates complex or specialty claims. Determines whether to return, deny or pay claims following organizational policies and procedures. Assists in training or mentoring new staff members. 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 You will work an 8-hour shift scheduled during our normal business hours of 8:00am-4:00pm CST. This...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Insurance Claims and Policy Processing Clerks
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

Technician, Data Preparation Senior

CGS Administrators, LLC
Located in Ohio
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Summary Performs advanced, varied clerical duties in accordance with ...
Details
Summary
About the job:
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 problems. May orient, train, assign and check the work of lower level employees and be designated as lead worker. Description Logistics: CGS...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Office Clerks, General
Career Level / Education:
High school diploma or equivalent
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Himalayas
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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