Be the Bridge Between Accuracy and Efficiency!

As an LTSS Claims Liaison, you’re not just processing claims—you’re shaping the backbone of provider success. This role is about transforming complexity into clarity by educating providers on claims submission, coding updates, and electronic transactions. You’ll be the go-to expert for resolving inquiries swiftly, developing impactful training strategies, and maintaining essential resources.

Your mission? Empower providers, strengthen compliance, and support workforce development so TennCare members receive timely, quality care. If you thrive on problem-solving, love turning challenges into solutions, and want to make a measurable difference in healthcare delivery—this is your opportunity to lead the way.

Join us and help build a smarter, stronger LTSS network—one claim at a time!

• Preference for candidates who have experience with medical claims & knowledge of LTSS programs in Tennessee.
• Candidates must live in Tennessee or a contiguous county.

Job 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. 
   

Job Qualifications

Education

• Bachelors degree in business or healthcare or relevant field or equivalent work experience required

Experience

• 3 years - Experience managing health plan accounts with multiple customer lines

Skills\Certifications

• 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

Job Specific Qualifications

• LTSS experience is highly preferred
• Strong claims experience and understanding is preferred

Number of Openings Available

1

Worker Type:

Employee

Company:

VSHP Volunteer State Health Plan, 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.