Working at CGS Administrators, LLC Are you looking to be a part of a great professional team working in a fast paced environment where you will be valued and can make a difference? Do you enjoy working with project management processes? Agile and Waterfall methodologies? CGS Administrators is based in Nashville, TN located in the lovely One Century Place Conference Center

Responsible for the accountability and supervision of different aspects of accounting functions for different lines of business. This involves approving journal entries, analyzing balances, account payables, expense tracking, researching data and assisting to identify variances. In addition, this position ensures that all regulations for each line of business are followed

Researches the substance of complex appeal or retrospective review requests including pre pay and post payment review appeal requests. Provides thorough clinical review or benefit analysis to determine if the requested services meet medical necessity guidelines. Documents decisions within mandated timeframes and in compliance with applicable regulations or standards. Desc

Performs non medical reviews and processes redetermination letters. Description Performs non medical reviews and processes redetermination letters ensuring timeliness and accuracy. Prepares unit reports, analyzes and interprets workload, and processes issues utilizing various software tools. Updates letters and documents within the department when necessary. May gather an

Conducts market/product/competitor research to be used in development of new products. Completes all marketing Requests for Proposals (RFPS)/Request for Information (RFIS) for CHC marketing, Major Group marketing, BlueChoice, and other divisions/cost centers. Develops/maintains databases of information for the RFPS and RFIS. Collects/analyzes market data and provides mana

Coordinates the overall proposal management process and provides guidance into the proposal related policies, processes, and procedures. Facilitates all phases of the proposal life cycle to ensure complete, compliant, responsive, and customer centric proposals are delivered on time for various solicitations (RFPs, RFIs, RFQs, task orders, etc.) ranging from minimum size a

Develops comprehensive reports and analyzes data in order to identify patterns and trends. Assists in creating materials that aid in illustrating analytical/data findings. Assists with sophisticated data interpretation, compilation, and verification to guide departmental efforts. Description Designs, codes, maintain and executes simple to complex database programs for the

Working at DocFinity Are you looking to be a part of great professional team where you will be valued and can make a difference? Do you enjoy creating test plans and capturing requirements? Maybe you like finding a solution to a problem while being innovative! If this sounds like you, then look no further and join DocFinity! DocFinity, a division of Companion Data Service

Prepare and file insurance premium tax returns. Monitor and/or reconcile assigned general ledger accounts of a complex nature, process complex accounting activity, resolve variances, and/or document procedures to ensure accuracy of accounting information and/or financial reports, and/or compliance with established rules and/or regulations. Description Prepares annual, qua

Palmetto GBA is a part of the Celerian Group, a consortium of companies which are subsidiaries of BlueCross BlueShield of South Carolina. Palmetto GBA helps government and private health care plans navigate the complexities of benefits administration. We are a leading provider of technical and administrative services for the federal government and our principal business i

Working at CGS Administrators, LLC Are you looking to be a part of a great professional team working in a fast paced environment where you will be valued and can make a difference? How about working with various applications and software systems where innovation takes place? Or maybe you like finding a solution to a problem while being innovative? CGS Administrators is ba

Working at CGS Administrators, LLC Are you looking to be a part of a great professional team working in a fast paced environment where you will be valued and can make a difference? How about working with various applications and software systems where innovation takes place? Or maybe you like finding a solution to a problem while being innovative? CGS Administrators is ba

Responsible for overall coordination, status reporting, and stability of project oriented work efforts. Responsible for moderate number of work efforts simultaneously that vary from a smaller to a moderate scale, with smaller number of hours to moderate number of hours, and with moderate system impacts and moderate scope and complexity. Adheres to project management proce

Responsible for analysis, design, programming, and implementation of the most complex applications tasks and projects in the area. Devise feasible, logical procedures to resolve business problems through the use of computer resources. Formulate scope and objectives through research to develop or modify complex systems. Provide technical direction and support in the develo

As member of the senior management team, provides administrative oversight to the medical staff, analyzes medical review utilization data, researches new medical procedures or technology, and acts as a resource to providers and internal staff on issues concerning medical policies. May also write and revise medical policies. Description Why should you join the BlueCross Bl