Hybrid Appeals & Grievance Intake Analyst

BlueCross BlueShield of Tennessee; Chattanooga (TN); Hybrid; USD 42,000 - 62,000; Full time

Job summary

BlueCross BlueShield of Tennessee is seeking an Appeals & Grievance Intake Analyst in hybrid mode in Chattanooga, TN. You will review and analyze documents from multiple intake channels, transfer data into internal systems, and route cases to the correct teams for processing.

The role emphasizes accuracy, data integrity, and timely resolution. You will support CMS guidelines, manage a high volume of documents, and work independently in a fast-paced environment, with an on-site rotation and

Qualifications

• High School Diploma or equivalent.
• 1 year - Experience in claims or customer service required.
• Experience interpreting CMS regulations and guidelines related to appeals, grievances and complaints

Responsibilities

• Receive, triage, and distribute work from all sources including hardcopy mail, fax, multiple GM mailboxes, Imaging, department Quality Improvement Organization-fast appeals calls, etc. and documenting the substance of the appeal or grievance/complaint in all applicable systems according to timeliness requirements.
• Following up with members and/or providers regarding additional information needs including medical records and Appointment of Representative Forms.
• Mail and fax all departmental outgoing correspondence timely according to CMS notification requirements.
• Maintain knowledge of CMS regulations and guidelines affecting the appeal/grievance/complaint process.
• Identifying information that needs to be rerouted to the appropriate person or area, ensuring that all work has been accurately distributed each day.

Skills

Attention to detail

Documentation abilities

Organizational skills

Time management

Oral and written communication

Interpersonal skills

Managing multiple projects

CMS regulations knowledge

Facets/CareAdvance/Imaging proficiency

Education

High School Diploma or equivalent

Tools

Facets

CareAdvance

Imaging

Job description

BlueCross BlueShield of Tennessee is seeking an Appeals & Grievance Intake Analyst in hybrid mode in Chattanooga, TN. You will review and analyze documents from multiple intake channels, transfer data into internal systems, and route cases to the correct teams for processing.

The role emphasizes accuracy, data integrity, and timely resolution. You will support CMS guidelines, manage a high volume of documents, and work independently in a fast-paced environment, with an on-site rotation and