LTSS Provider & FEA Liaison

BlueCross BlueShield of Tennessee • Chattanooga, TN

19d

About The Position

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.

Requirements

• 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

Nice To Haves

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

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees