Assistant, Qualified Independent Contractor

Summary

Provides all redetermination case file information within the specified time requirement while maintaining accuracy and departmental standards. Suspends claims in applicable claim system and tracks all data.

Description

Logistics CGS is a subsidiary of BlueCross BlueShield of South Carolina. This is a full-time position (40 hours/week), Monday–Friday, 8:00 AM–4:30 PM CST. The role is hybrid after training (approximately six weeks), with onsite work required at 26 Century Boulevard, Suite NT600, Nashville, TN 37214-3685. This role supports the QIC (Qualified Independent Contractor) workload tied to DME Medicare appeals.

Centers for Medicare & Medicaid Services (CMS) Requirements

• Candidates must have resided in the United States for at least three (3) of the last five (5) years.

What You’ll Do

• Perform the administrative function of validating and processing reconsideration requests within designated timeliness and quality standards.
• Identify, retrieve, and prepare documentation for batching; build case files in the established format; annotate claims in the appropriate claim and internal systems for proper tracking and reporting;
• Copy, fax, and log data.
• Maintains databases and updates the system for tracking purposes to ensure timeliness and quality standards are met.

Qualifications

• Required Education: High School Diploma or equivalent
• Required Work Experience: 1 year administrative support, clerical, or claims experience
• Required Skills and Abilities: Good organizational, decision making, customer service skills. Detail oriented. Analytical or critical thinking skills
• Preferred Work Experience: 2 years-clerical, research, or related office experience

Software and Tools

• Microsoft Office