[Hiring] Clinical Assistant @BlueCross BlueShield of Tennessee

Role Description

In this role, you will support BlueCare Clinical Support by serving TennCare members across Tennessee as part of a collaborative team. You will help maintain timely, accurate workflows that support effective service delivery and a positive member experience.

This position combines phone-based provider support with fax-based administrative responsibilities. You will:

• Communicate with providers to address questions and support requests.
• Manage fax requests and support clinical operations through accurate and efficient workflow management.
• Balance communication, problem-solving, and administrative work in a fast-paced environment.

The ideal candidate is:

• A quick learner who is productive and goal-oriented.
• Open-minded and adaptable to change.
• Detail-oriented and committed to a strong work ethic and integrity.

Success in this role requires:

• The ability to adjust to changing priorities.
• Comfort working across both phone and fax workflows.
• A focus on quality and productivity.
• Familiarity with medical terminology (preferred).

Note: This is a remote role within a collaborative and supportive team environment. Team members rotate weekly among three shifts. The earliest shift begins at 7:45 a.m. ET, and the latest shift ends at 6:00 p.m. ET to meet State of Tennessee coverage requirements. The role includes a structured training and preceptor period, with full training typically completed in approximately six weeks.

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

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via email, the Internet, or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.