Appeals Specialist Non-Medical Reviews & Redeterminations

CGS Administrators LLC; Nashville (TN); Hybrid; USD 50,000 - 65,000; Full time

Benefits offered by this job

Subsidized health plans, dental and/or

Job summary

CGS Administrators LLC seeks an Appeals Specialist to perform non-medical reviews and process redetermination letters within a structured health benefits environment. The role emphasizes timeliness, accuracy, and clear communications with claimants and internal teams.

Hybrid work is available after training; normal hours are 8 to 5 CT, Monday–Friday, with primary location in Nashville, TN. Requires CMS clearance and strong Microsoft Office proficiency.

Qualifications

• High School Diploma or equivalent required.
• Demonstrated proficiency with word processing and spreadsheets.
• Excellent written and verbal communication, organization and judgment.

Responsibilities

• Performs non-medical reviews and processes redetermination letters with timeliness and accuracy.
• Prepares unit reports, analyzes workload, and uses software tools to resolve issues.
• Updates letters and documents within the department when needed.
• May gather and prepare documentation for legal inquiries and requests.

Skills

Word processing

Spreadsheets

Communication skills

Organization

Customer service

Grammar punctuation

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

CGS Administrators LLC seeks an Appeals Specialist to perform non-medical reviews and process redetermination letters within a structured health benefits environment. The role emphasizes timeliness, accuracy, and clear communications with claimants and internal teams.

Hybrid work is available after training; normal hours are 8 to 5 CT, Monday–Friday, with primary location in Nashville, TN. Requires CMS clearance and strong Microsoft Office proficiency.