[Hiring] Clinical Assistant @BlueCross BlueShield of Tennessee

Role Description

In this role, you will support BlueCare Plus Clinical Review Managers at BCBST by serving as a key point of contact for providers and healthcare partners. You will assist providers by:

• Answering questions
• Loading authorization faxes
• Entering authorization requests received by phone
• Directing providers through the peer-to-peer review process
• Ensuring timely, accurate support through both phone interactions and administrative coordination

You will play an important role in improving the overall provider experience by delivering compassionate, member-centered support, responding to inquiries with empathy, and helping ensure smooth coordination of care.

The ideal candidate has experience in a medical office setting or working with senior populations. Success in this role requires:

• Strong communication skills
• Patience
• Attention to detail
• The ability to work independently
• Familiarity with medical terminology (preferred)

Note:

• This is a remote role within a collaborative and supportive team environment
• Candidates must be able to work weekly rotating shifts of 7:30–4:00 p.m., 8:00–4:30 p.m., 8:30–5:00 p.m. and 9:00-5:30 p.m. EST
• Overtime may be required based on business needs

Qualifications

• High School Diploma or equivalent
• 1 year of customer service experience is required

Requirements

• Proficient in Microsoft Office (Outlook, Word, Excel, and PowerPoint)
• Proficient oral and written communication skills
• Proficient interpersonal and organizational skills
• Exceptional time management skills
• Ability to work independently under general supervision and collaboratively as part of a team in a fast-paced environment
• Independent, sound decision-making and problem-solving skills
• If current employee with the company, must meet minimum performance expectations
• Extensive knowledge of all aspects of Utilization Management, Care Management, and Behavioral Health
• Knowledge and understanding of medical terminology
• Solid knowledge and understanding of provider reimbursement methodologies, ICD-10-CM, CPT, HCPCS, and UB-92 coding, UHDDS coding guidelines, AHA Coding Clinic
• Ability to talk and type simultaneously in a clear and concise manner while interacting with customers

Company Description

BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.

Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page: BCBST's EEO Policies/Notices

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity.