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bcbsazcareers

Imagine doing life-changing work and helping more than one million Arizonans live healthier and longer lives. That’s the kind of satisfaction you’ll find when you work here. Our exceptional teams in Phoenix, Tucson, Chandler, and Flagstaff have been transforming healthcare for more than 80 years. Explore what's possible with a career at Blue Cross® BlueShield® of Arizona

Related companies:

🏢 BCBSAZCareers
🏢 Blackbird Health
👥 10-100💰 $17,000,000 Series A 11 months agoMedicalInformation TechnologyWellnessHealth Care
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🏢 bonsecoursmercyhealthcareers

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🔥 Registered Nurse Coder - DRG Reviewer (Remote)
Posted about 1 month ago

📍 United States of America

🧭 Full-Time

🔍 Health Insurance

  • Required Work Experience: 1-8 years in clinical and health insurance.
  • Managed care experience focusing on Utilization Management, Claims, Medical Review, etc.
  • Required Education: Associate's Degree in a healthcare field or Nursing Diploma.
  • Required Licenses: Active RN license in Arizona.
  • Required Certifications: Certified Medical Coder.

  • Perform in-depth analysis and clinical review of provider claims related to medical coverage.
  • Prepare audit cases for Medical Directors and respond to inquiries.
  • Analyze medical records against billing and charge appropriateness.
  • Consult with internal and external parties for project resolution.
  • Meet performance goals for quality and timeliness.
  • Participate in continuing education and maintain compliance with regulations.

LeadershipProblem SolvingOrganizational skillsDocumentationComplianceInterpersonal skills

Posted about 1 month ago
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🔥 Med Appeals and Grievance Specialist II (remote)
Posted 2 months ago

📍 United States of America

🧭 Full-Time

🔍 Health Insurance

  • 1-9 years of experience in clinical and health insurance, varying by level.
  • Managed care experience with a focus in Utilization Management, Prior Authorization, Claims, Case Management or Medical Appeals.
  • An Associate’s Degree in a healthcare-related field or a Nursing Diploma.
  • Active and unrestricted license to practice as an RN, PT, or LMSW in Arizona.

  • Perform in-depth analysis and clinical review for member and provider appeals, grievances, and corrected claims.
  • Respond to customer inquiries through written and verbal communication.
  • Analyze medical records to determine the appropriateness of requests.
  • Maintain accurate records and meet performance goals.
  • Consult with internal and external entities to resolve inquiries.

LeadershipCommunication SkillsAnalytical SkillsCollaborationMicrosoft ExcelProblem-solving skills

Posted 2 months ago
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