Senior Medicare Appeals Manager

260 CGS Administrators, LLC; Nashville (TN); On-site; USD 70,000 - 95,000; Full time

Benefits offered by this job

Subsidized health plans

Dental and vision coverage

401k with company match

Life Insurance

Paid Time Off

On-site cafeterias and fitness centers

Education Assistance

Service Recognition

National discounts

Job summary

BlueCross BlueShield of South Carolina (CGS) is seeking an Appeals Manager to oversee operations for a Medicare service contract. The role requires managing staff, ensuring CMS guidelines, and coordinating with other functional teams.

The position is full-time and onsite at the One Century Plaza location in Nashville, TN, with a 40–45 hour workweek and occasional overtime. U.S. citizenship is required for government clearance.

Qualifications

• Bachelor's degree required.
• 5 years in a leadership role overseeing staff in Medicare or similar setting (or equivalent military experience).
• Excellent verbal and written communication; strong analytical and organizational skills.
• Ability to handle confidential information; proficiency with Word/Excel.
• Knowledge of CMS guidelines and performance standards would be a plus.

Responsibilities

• Oversee departmental staff and programs.
• Ensure CMS guidelines and performance standards are met.
• Collaborate with other areas to resolve issues and participate in special projects.

Skills

Verbal and written communication

Judgment and analytical thinking

Grammar and spelling

Confidential information handling

Word processing & spreadsheets

Customer service

Education

Bachelor's degree

Business Administration / Healthcare Administration (preferred)

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina (CGS) is seeking an Appeals Manager to oversee operations for a Medicare service contract. The role requires managing staff, ensuring CMS guidelines, and coordinating with other functional teams.

The position is full-time and onsite at the One Century Plaza location in Nashville, TN, with a 40–45 hour workweek and occasional overtime. U.S. citizenship is required for government clearance.