[Hiring] Initial Clinical Reviewer @Blue Cross Blue Shield of Arizona

Role Description

Responsible for identifying, researching, processing, resolving, and responding to inquiries from internal and external customers with emphasis on excellence, privacy, compliance and versatility within the health insurance industry.

Qualifications

• 2 years of experience in clinical field of practice, health insurance, or other health care related field
• Associate’s Degree in general field of study or Post High School Nursing Diploma or Certification (LPN only) from an approved program
• Active, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as a behavioral health professional such as LCSW, LPC, LISAC LMFT, or licensed psychologist (Psy.D. or Ph.D.), OR an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN, OR an active, current, and unrestricted license to practice in the State of Arizona as an LPN.

Requirements

• 3 years of experience in clinical field of practice, health insurance, or other health care related field (Preferred)
• Bachelor's Degree in Nursing or related field of study (Preferred)
• Active, current, and unrestricted license to practice in the State of Arizona as a Registered Nurse (Preferred)

Benefits

• Full-time work schedule defined as working at least 40 hours per week, plus any additional hours as requested or needed to meet business requirements

Company Description

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

• Hybrid workforce strategy called Workability, offering flexibility with how and where employees work.
• Onsite requirements may change in the future based on business need and job responsibilities.
• This remote work opportunity requires residency and work to be performed within the State of Arizona.