Appeals & Grievance Intake Analyst

BlueCross BlueShield of Tennessee

. Receive, triage, and distribute work from hardcopy mail, fax, GM mailboxes, Imaging, and Quality Improvement Organization-fast appeals calls .

Posted 9/22/2026full-timeChattanooga • Tennessee • United StatesJuniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in managing appeals, grievances, and complaints while adhering to CMS regulations. Proficient in documentation and communication, ensuring timely and accurate processing of inquiries and correspondence.

Highest-signal resume keywords

Claims ManagementCMS Regulations KnowledgeFacets ProficiencyExceptional Documentation AbilitiesOrganizational Skills

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Claims ProcessingDocumentationAppeals ManagementGrievance ManagementUtilization Management

Soft Skills

Attention to DetailTime ManagementInterpersonal SkillsOrganizational SkillsCommunication Skills

Tools & Technologies

FacetsCareAdvanceImaging

Certifications & Qualifications

High School Diploma or Equivalent

Industry Keywords

CMS GuidelinesQuality Improvement OrganizationMember BenefitsAppointment of Representative Forms

About the role

Key responsibilities & impact

Receive, triage, and distribute work from hardcopy mail, fax, GM mailboxes, Imaging, and Quality Improvement Organization-fast appeals calls
Document the substance of appeals, grievances, and complaints in applicable systems according to timeliness requirements
Utilize multiple systems to document appeals, grievances, and complaints
Reroute correspondence to the appropriate person or area
Follow up with members and providers regarding additional information, including medical records and Appointment of Representative Forms
Document Facets inquiries, claims, utilization management, case management notes, and member benefits
Mail and fax departmental outgoing correspondence according to CMS notification requirements
Maintain knowledge of CMS regulations and guidelines affecting the appeal, grievance, and complaint process
Ensure all work is accurately distributed each day

Requirements

What you’ll need

High School Diploma or equivalent
1 year of experience in claims or customer service required
Attention to detail, exceptional documentation abilities, and organizational skills
Exceptional time management skills
Excellent oral and written communication skills
Strong interpersonal and organizational skills
Ability to manage multiple projects and numerous personnel simultaneously
Knowledge of CMS regulations and guidelines related to appeals, grievances and complaints
Proficient with Facets, CareAdvance and Imaging
Current employees must meet minimum performance expectations
Ability to work Monday–Friday, 8:00AM–4:00PM ET, with rotating call/late stay ending at 6:00PM ET
Ability to participate in an on-site rotation approximately one week per month

Benefits

Comp & perks

Monday–Friday, 8:00AM–4:00PM ET schedule, with latest shift ending at 6:00PM ET
Remote location-specific work arrangement
On-site rotation approximately one week per month
Additional flexibility based on business needs