BlueCross BlueShield of Tennessee
LTSS Specialist I
BlueCross BlueShield of Tennessee, Nashville, Tennessee, United States, 37201
LTSS Specialist I
As an LTSS Specialist I you'll be at the heart of a mission-driven team dedicated to improving the lives of individuals in the CHOICES and ECF CHOICES programs. This is more than just a jobit's an opportunity to make a meaningful impact by supporting care coordination, ensuring continuity of services, and helping members navigate their healthcare journey. You'll collaborate with clinical teams, providers, and families to deliver person-centered support, while also applying your analytical skills to resolve complex inquiries and streamline service delivery. If you're passionate about making a difference and thrive in a dynamic, team-oriented environment, we'd love to hear from you. Job Responsibilities
Ensure compliance with contractual obligations and government regulations are sustained to avoid penalties. Review and complete reports as directed by management. Analyze and make comparisons on person center support plan for members and issues. Manage services on person center support plan for members, issue and verify authorizations for services, and collaborate with Care Coordinators/Support Coordinators to ensure accurate service provision. Job Qualifications
Education High School Diploma or equivalent Experience 2 years - Experience in claims or customer service required Skills/Certifications Proficient in Microsoft Office (Outlook, Word, Excel and Powerpoint) Capacity to solve problems and manage multiple assignments with critical deadlines Effective time management skills Excellent oral and written communication skills Strong interpersonal and organizational skills Solid knowledge and understanding of provider reimbursement methodologies, ICD-9-CM, CPT, HCPCS and UB-92 coding, UHDDS coding guidelines, AHA Coding Clinic Number of Openings Available: 1 Worker Type: Employee Company: VSHP Volunteer State Health Plan, Inc Applying for this job indicates your acknowledgement and understanding of the following statements: 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:
As an LTSS Specialist I you'll be at the heart of a mission-driven team dedicated to improving the lives of individuals in the CHOICES and ECF CHOICES programs. This is more than just a jobit's an opportunity to make a meaningful impact by supporting care coordination, ensuring continuity of services, and helping members navigate their healthcare journey. You'll collaborate with clinical teams, providers, and families to deliver person-centered support, while also applying your analytical skills to resolve complex inquiries and streamline service delivery. If you're passionate about making a difference and thrive in a dynamic, team-oriented environment, we'd love to hear from you. Job Responsibilities
Ensure compliance with contractual obligations and government regulations are sustained to avoid penalties. Review and complete reports as directed by management. Analyze and make comparisons on person center support plan for members and issues. Manage services on person center support plan for members, issue and verify authorizations for services, and collaborate with Care Coordinators/Support Coordinators to ensure accurate service provision. Job Qualifications
Education High School Diploma or equivalent Experience 2 years - Experience in claims or customer service required Skills/Certifications Proficient in Microsoft Office (Outlook, Word, Excel and Powerpoint) Capacity to solve problems and manage multiple assignments with critical deadlines Effective time management skills Excellent oral and written communication skills Strong interpersonal and organizational skills Solid knowledge and understanding of provider reimbursement methodologies, ICD-9-CM, CPT, HCPCS and UB-92 coding, UHDDS coding guidelines, AHA Coding Clinic Number of Openings Available: 1 Worker Type: Employee Company: VSHP Volunteer State Health Plan, Inc Applying for this job indicates your acknowledgement and understanding of the following statements: 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: