Logo for BlueCross BlueShield of Tennessee

Claims Trainee

Role overview

Qualifications

  • High School Diploma or equivalent
  • Proficient in Microsoft Office (Outlook, Word, Excel and Powerpoint)
  • Proficient oral and written communication skills
  • Exceptional time management skills

Responsibilities

  • Routing claim issues to next level or appropriate support areas; following up to ensure completion
  • Inputting, reviewing and validating the claims data received; evaluating their reliability and effectiveness in line with coverage and appraisal
  • Assisting in routine claim analysis and final determination; delivering administrative support throughout all claim handling processes
  • Performing basic investigator tasks; gathering and documenting relevant information as a preliminary investigation

Key facts

Other skills

  • Microsoft Office
  • Communication
  • Social Skills
  • Time Management
  • Decision Making
  • Problem Solving

About the company

BlueCross BlueShield of Tennessee logo

BlueCross BlueShield of Tennessee

Health Insurance (Payers)

As Tennessee's largest health plan, we've been helping Tennesseans find their own unique paths to good health for more than 70 years. More than that, we're your neighbors and friends – fellow Tennesseans with deep roots of caring tradition, a focused approach to physical, financial and community good health for today, and a bright outlook for an even healthier tomorrow. Our mission is simple: peace of mind through better health. We're an independent, not-for-profit, locally governed health plan company – meaning we live and work alongside our Tennessee business customers and plan members. Our 6,000 employees across the state have built our strong reputation for integrity, excellent service and community leadership. But we are also part of the BlueCross BlueShield Association, a nationwide association of health care plans. Because of this, our plan members have access to the same quality health benefits while traveling or living out of state that they have while in Tennessee. © 2018 BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the BlueCross BlueShield Association.

Company details

Company typeXLarge
IndustryHealth Insurance (Payers)
Company size5001 - 10000

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Job description

BCBST is hiring Claims Trainees!

We’re looking for a detail-oriented, service-minded professional who thrives in a structured environment and takes pride in getting the details right—someone who understands, interprets, and applies “on-line” guidelines to make claims decisions and has the ability to effectively utilize time to meet established production and accuracy goals.

In this role, you’ll handle routine, claim-specific work by following online guidelines, inputting/reviewing/validating incoming claims data, and evaluating information for reliability and completeness.  You’ll route claim questions or exceptions to the next level or appropriate support teams and follow up to ensure completion.

Success in this role means claim handling steps are completed accurately and efficiently, issues are escalated and resolved promptly, documentation is consistently audit-ready, communication is professional and timely throughout the process, and you’re able to pass required assessments as part of the role expectations.  We foster a culture where innovation is encouraged. That includes using AI‑enabled tools responsibly to support everyday work, guided by proven workflows, templates, and policies. As roles become more advanced, we expect employees to leverage AI more broadly to transform how we serve members.

Ready to take the next step?  Apply today if you enjoy problem-solving, value quality and accuracy, and want to support a strong claims experience through dependable follow-through and clear communication.

Notes:

  • This is a remote role.
  • Employment begins 10-12-26.
  • Training lasts approximately 12 weeks and runs 8:00 a.m. – 4:45 p.m. EST, Monday-Friday.  Camera-on required during training.
  • After training and learning period (usually 6 months after training completion), employees will have flexibility to work an 8-hour shift within the hours of 5:00 a.m. – 7:00 p.m. EST.
  • Overtime may be required as business needs arise.
  • Must be able to pass required assessments.
  • Sponsorship is not available for this position.

Job Responsibilities

  • Routing claim issues to next level or appropriate support areas; following up to ensure completion.
  • Inputting, reviewing and validating the claims data received; evaluating their reliability and effectiveness in line with coverage and appraisal.
  • Assisting in routine claim analysis and final determination; delivering administrative support throughout all claim handling processes.
  • Performing basic investigator tasks; gathering and documenting relevant information as a preliminary investigation.
  • Must be able to pass required testing.
  • Work overtime as required.

Job Qualifications

Education

  • High School Diploma or equivalent

Skills\Certifications

  • Proficient in Microsoft Office (Outlook, Word, Excel and Powerpoint)
  • Proficient oral and written communication skills
  • Proficient interpersonal and organizational skills
  • Exceptional time management skills
  • Independent, Sound decision-making and problem-solving skills
  • If current employee with the company, must meet minimum performance expectations

Number of Openings Available

9

Worker Type:

Employee

Company:

BCBST BlueCross BlueShield of Tennessee, Inc.

Applying for this job indicates your acknowledgement and understanding of the following statements:

BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.

Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:

BCBST's EEO Policies/Notices

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
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