Appeals Specialist – CGS Admin

Job not on LinkedIn

🕒 August 18

🎸 Tennessee – Remote

🎸 Tennessee – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 31%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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CGS Administrators, LLC

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

CGS Administrators, LLC is a company that provides scalable administrative services focused on optimizing operational performance and reducing costs for health plans. With over 50 years of experience, CGS delivers a range of services including credentialing, member services, claims processing, and fraud prevention to the Centers for Medicare & Medicaid Services (CMS) and various healthcare providers. Their aim is to streamline operations and enhance customer satisfaction, contributing positively to the healthcare delivery system.

📋 Description

• Perform non-medical reviews and process redetermination letters, ensuring timeliness and accuracy • Prepare unit reports • Analyze and interpret workload • Process issues using various software tools • Update letters and departmental documents as necessary • Gather and prepare documentation for legal inquiries and administrative requests • Work fully remotely or onsite at 26 Century Blvd, Suite ST610, Nashville, TN 37214

🎯 Requirements

• High School Diploma or equivalent • 2 years job related field experience • Demonstrated proficiency in word processing and spreadsheet software • Excellent organizational, customer service, written and verbal communication skills • Good judgment skills • Proficiency in spelling, punctuation, and grammar • Microsoft Office proficiency • Experience in medical claims processing, appeals, or coding strongly preferred • Medicare Part B experience preferred • Strong computer proficiency, including navigating multiple systems and working across dual screens efficiently • Intermediate-level Excel skills • Experience creating letters and documents by reviewing appeals and extracting information with a high degree of accuracy • Ability to work an 8-hour shift schedule, with work hours starting between 6:00 AM and 7:30 AM Central Time • Ability to work occasional overtime when necessary

🏖️ Benefits

• Subsidized health plans, dental and vision coverage • 401k retirement savings plan with company match • Life Insurance • Paid Time Off (PTO) • On-site cafeterias and fitness centers in major locations • Education Assistance • Service Recognition • National discounts to movies, theaters, zoos, theme parks and more • Supplemental pay for health coverage until enrollment is complete • Health insurance enrollment required for SCA employees • Opportunity to develop skills, advance careers and contribute to company growth