full-timeUnited StatesToday
Appeals & Grievance Nurse Analyst
BlueCross BlueShield of Tennessee
Salary not specified
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About this role
We are hiring an Appeals & Grievance Nurse Analyst at BCBST! In this role, you will review and process appeals submitted by members and providers, ensuring timely and accurate resolution in compliance with CMS, Medicare, and TennCare guidelines. You will evaluate cases, determine next steps, and manage multiple priorities while meeting strict turnaround times. You will also review clinical and medical records, summarize findings for Medical Director review, and operate within turnaround times as short as 24–72 hours.…