Remote Clinical Assistant: UM & Admin Support

BlueCross BlueShield of Tennessee; United States; Remote; USD 38,000 - 46,000; Full time

Job summary

BlueCross BlueShield of Tennessee is seeking a Clinical Assistant to support BlueCare Clinical Support for TennCare members across Tennessee. The role combines phone-based provider support with fax-based administrative tasks, handling inquiries, and enabling efficient workflow management.

The ideal candidate learns quickly, is detail-oriented, and works well in a fast-paced team. Familiarity with medical terminology is preferred.

Qualifications

• High School Diploma or equivalent required.
• 1 year of customer service experience required.
• Familiarity with medical terminology preferred.
• Proficient in Microsoft Office and good written communication.

Responsibilities

• Screen incoming calls and/or faxes for UM/CM and direct to appropriate area.
• Investigate and resolve customer inquiries and claims; maintain department goals.
• Document data and load organization determinations per internal policy.
• Interact with members, hospital and provider staff and provide UM status updates.
• Identify diagnosis and/or procedure codes during notification and prior authorization.
• Complete digital literacy assessment.
• Attendance and punctuality mandatory; schedule rotations.
• Overtime as required.

Skills

Oral and written communication

Interpersonal skills

Time management

Independent work

Team collaboration

Problem solving

Medical terminology

Utilization Management knowledge

ICD-10-CM/CPT understanding

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

BlueCross BlueShield of Tennessee is seeking a Clinical Assistant to support BlueCare Clinical Support for TennCare members across Tennessee. The role combines phone-based provider support with fax-based administrative tasks, handling inquiries, and enabling efficient workflow management.

The ideal candidate learns quickly, is detail-oriented, and works well in a fast-paced team. Familiarity with medical terminology is preferred.