Appeals Specialist
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Before you apply
LocationNashville, Tennessee
Work modeon-site
Typefull-time
Company size7+ people
First seenOct 6, 2026 · 1mo ago
Verified live5h ago
At a glanceSummarised by Seekless from the posting.
Performs non-medical reviews and processes redetermination letters
CMS Security Clearance required
Full-time (40 hours/week) Monday-Friday
This position is not eligible for sponsorship now or in the future
Summary
We are currently hiring a Part A/HHH Appeals Specialist at one of our subsidiary companies called CGS Administrators. CGS has been a proven provider of administrative and business services for state Medicaid agencies, managed care organizations, commercial health plans, Medicaid members, Medicare beneficiaries, healthcare providers, and medical equipment suppliers for more than 50 years.
Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.
Description
Position Purpose: An Appeals Specialist performs non-medical reviews and processes redetermination letters.
Logistics: CGS - one of BlueCross BlueShield’s South Carolina subsidiary companies.
Requirements
Government Clearance: This position requires CMS Security Clearance as it falls within a division subject to Centers for Medicare and Medicaid Services residency requirements.
Legal
SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). Under the McNamara-O’Hara Service Contract Act (SCA), employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date.
Location: This position is full-time (40 hours/week) Monday-Friday located onsite at One Century Plaza, Nashville, TN.
Sponsorship: This position is not eligible for sponsorship now or in the future.