[Remote] LTSS Provider & FEA Liaison

Note: The job is a remote job and is open to candidates in USA. BlueCross BlueShield of Tennessee is seeking an LTSS Claims Liaison to empower providers and support workforce development. This role involves educating providers on claims submission, resolving inquiries, and developing training strategies to enhance compliance and quality care for TennCare members. Responsibilities • Provide for education and technical assistance regarding appropriate claims submission processes and requirements including, coding updates, electronic claims transactions and electronic funds transfers. Research and resolve claims issues and inquiries promptly • Develop strategies to improve the effectiveness of BlueCare claims education and technical assistance activities • Develop and maintain BlueCare provider resources i.e. provider manual, fee schedules, website, training materials • Provide education and assistance with consumer-directed workers to resolve problems and address inquires • May support initial and ongoing workforce development strategies and goals to support measurable actions to help ensure a qualified, competent, and sufficient workforce to consistently deliver needed services in a timely manner • Develop and initiate claims training and intervention to help provider obtain and retain compliance • Support ongoing quality initiatives for LTSS providers, and other TennCare amendment changes Skills • Bachelors degree in business or healthcare or relevant field or equivalent work experience required • 3 years - Experience managing health plan accounts with multiple customer lines • Working knowledge of healthcare claims, customer service, provider network contracting, and contract compliance • Ability to conduct root cause analysis, plan, organize and coordinate multiple projects • Ability to quickly take complex technical subjects and distill them into user-friendly presentations and digital communications • Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability • Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint) • Excellent oral and written communication skills • Strong interpersonal and organizational skills • Proven decision making and problem solving skills • Knowledge and understanding of TennCare contracts as well as state and federal regulatory requirements • Proficient in Facets and CareAdvance • Preference for candidates who have experience with medical claims & knowledge of LTSS programs in Tennessee • Candidates must live in Tennessee or a contiguous county • LTSS experience is highly preferred • Strong claims experience and understanding is preferred Company Overview • As Tennessee's largest health plan, we've been helping Tennesseans find their own unique paths to good health for more than 70 years. It was founded in 1945, and is headquartered in Chattanooga, Tennessee, USA, with a workforce of 5001-10000 employees. Its website is Apply tot his job