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Results based on filters ( 10 jobs found )

Senior Medical Director (Palmetto GBA)

CGS Administrators, LLC
Grove City, OH
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84495309 292544306 Internal Reference Number: R1045875 Summary Position ...
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Purpose As a member of the leadership team, you will oversee and direct the synthesis of data and clinical knowledge in the development of information that is used to inform the detection, correction and prevention of claims payment errors. You will lead a Medical Review team in the development and implementation of an efficient and effective medical review strategy which includes the integration of policy and education, that optimizes critical medical review cycle times. In this role you will also serve as the Medical...
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Applied Math
5
Graphic Literacy
5
Workplace Documents
5
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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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assistance, 401(k) United States, Tennessee, Nashville 2 Vantage Way ( Show on map ) Aug 26, 2025 Summary Working at CGS Administrators 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 philosophy,...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Information Technology Project Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Diversityjobs
Certifications / Licenses:
Cadastral Mapping Specialist
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
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Manager, Medical Review (RN Manager)

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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Tennessee, Nashville 2 Vantage Way ( Show on map ) Aug 22, 2025 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...
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:
Certified Registered Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Lead Claims Processor

CGS Administrators, LLC
Darbydale, OH
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84535522 292321866 Internal Reference Number: R1046338 Summary Functions as ...
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the team lead and subject-matter expert for a claims area. Responsible for creating reports, distributing workload and training new employees.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 from 8:00am-4:00pm CST and will be fully remote. SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the...
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Applied Math
4
Graphic Literacy
4
Workplace Documents
3
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Registered Nurse Senior Medical Reviewer (Medicare Part B Appeals) - CGS

CGS Administrators, LLC
Grove City, OH
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84495308 292300460 Internal Reference Number: R1045305 Summary We are ...
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currently hiring for a Registered Nurse Senior Medical Reviewer to join CGS, a Celerian Group Company and subsidiary of BlueCross BlueShield of South Carolina. The team the position will work on handles Medicare Part B DME claims. In this role you will Act as Team Lead for specialty programs, medical review, utilization management, and case management areas by providing assistance and support to unit supervisor/manager by giving direction/guidance/training to staff. You will also ensure appropriate levels of healthcare...
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From:
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Certifications / Licenses:
Workkeys
Applied Math
4
Graphic Literacy
5
Workplace Documents
4
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Medicare Cost Reporting Auditor III

CGS Administrators, LLC
Darbydale, OH
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84455707 292281521 Internal Reference Number: R1043973 Summary Position ...
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Purpose: Responsible 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 Logistics: Palmetto GBA- one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is full-time (40-hours/week) Monday-Friday working REMOTE in the U.S., or onsite at our 17 Technology Circle, Columbia, SC location. You will work an 8-hour shift scheduled during our...
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From:
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Certifications / Licenses:
Workkeys
Applied Math
5
Graphic Literacy
5
Workplace Documents
6
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Chief Medical Officer - Medicare DME

CGS Administrators, LLC
Darbydale, OH
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84434502 292270984 Internal Reference Number: R1045844 Summary Why should ...
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About the job:
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 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 Southeast. We also have a diverse family of subsidiary...
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From:
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Certifications / Licenses:
Workkeys
Applied Math
5
Graphic Literacy
6
Workplace Documents
6
apply
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CMMI Quality Assurance Auditor- CGS Administrators, LLC

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 2 Vantage Way ( Show on map ) Jul 11, 2025 Summary Working at CGS Administrators 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 are seeking a passionate, collaborative and experienced CMMI Quality Assurance Auditor to...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Accountants and Auditors
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Diversityjobs
Certifications / Licenses:
Enterprise Project Management
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Medicare Auditor III

CGS Administrators LLC
Illinois
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CGS Administrators LLC life insurance, paid time off, 401(k) United States, ...
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About the job:
Illinois Jul 09, 2025 Summary Responsible 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 This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift scheduled during our normal business hours 8:00am-5:00pm. It may be necessary, given the business needs to work occasional overtime. You may be required...
Location:
Illinois
Job Type:
Full-Time
Permanent
Occupation:
Accountants and Auditors
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Diversityjobs
Certifications / Licenses:
Certified Internal Auditor
Certified Public Accountant
Certified Information Systems Auditor
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Lean Operational Excellence Project Manager - CGS

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 ) Jul 02, 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:
Project Management Specialists
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Diversityjobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
4
Graphic Literacy
5
Workplace Documents
5
apply
Detailed Job Information
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Salary: Six Figures Jobs ($100K+)
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