Frontline Appeals & Grievance Intake Specialist

bcbst; United States; On-site; USD 45,000 - 60,000; Full time

Job summary

BCBST BlueCross BlueShield of Tennessee, Inc. is seeking an Appeals & Grievance Intake Analyst to review and route intake documents, transfer data into internal systems, and ensure timely distribution to relevant teams.

The role emphasizes accuracy, critical thinking, and independent work in a fast-paced environment. Responsibilities include handling high-volume intake, documenting appeal details, and maintaining CMS compliance.

Qualifications

• High School Diploma or equivalent.
• 1 year - Experience in claims or customer service required.
• Attention to detail, exceptional documentation abilities, and organizational skills.
• Excellent oral and written communication skills.
• Strong interpersonal and organizational skills.
• Ability to manage multiple projects and numerous personnel simultaneously.
• Knowledge of CMS regulations and guidelines related to appeals, grievances and complaints.
• Proficient with Facets, CareAdvance and Imaging.

Responsibilities

• Receive, triage, and distribute work from all sources and document the substance of the appeal or grievance/complaint in applicable systems.
• Follow up with members/providers for additional information and document related inquiries, claims, and benefits.
• Mail and fax all departmental outgoing correspondence timely according to CMS requirements.
• Maintain knowledge of CMS regulations affecting the appeal/grievance/complaint process.
• Identify information that needs rerouting to appropriate person or area and ensure distribution each day.

Skills

Attention to detail

Documentation abilities

Time management

Oral & written communication

Interpersonal skills

Multi-project management

CMS regulations knowledge

Facets / CareAdvance / Imaging

Education

High School Diploma or equivalent

Tools

Facets

CareAdvance

Imaging

Job description

BCBST BlueCross BlueShield of Tennessee, Inc. is seeking an Appeals & Grievance Intake Analyst to review and route intake documents, transfer data into internal systems, and ensure timely distribution to relevant teams.

The role emphasizes accuracy, critical thinking, and independent work in a fast-paced environment. Responsibilities include handling high-volume intake, documenting appeal details, and maintaining CMS compliance.