LTSS Specialist I

As an LTSS Specialist I you’ll be at the heart of a mission-driven team dedicated to improving the lives of individuals in the CHOICES and ECF CHOICES programs. This is more than just a job—it’s an opportunity to make a meaningful impact by supporting care coordination, ensuring continuity of services, and helping members navigate their healthcare journey. You’ll collaborate with clinical teams, providers, and families to deliver person-centered support, while also applying your analytical skills to resolve complex inquiries and streamline service delivery. If you're passionate about making a difference and thrive in a dynamic, team-oriented environment, we’d love to hear from you.

Job Responsibilities

• Ensure compliance with contractual obligations and government regulations are sustained to avoid penalties.
• Review and complete reports as directed by management.
• Analyze and make comparisons on person center support plan for members and issues.
• Manage services on person center support plan for members, issue and verify authorizations for services, and collaborate with Care Coordinators/Support Coordinators to ensure accurate service provision.

Job Qualifications

Education

• High School Diploma or equivalent

Experience

• 2 years - Experience in claims or customer service required

Skills\Certifications

• Proficient in Microsoft Office (Outlook, Word, Excel and Powerpoint)
• Capacity to solve problems and manage multiple assignments with critical deadlines
• Effective time management skills
• Excellent oral and written communication skills
• Strong interpersonal and organizational skills
• Solid knowledge and understanding of provider reimbursement methodologies, ICD-9-CM, CPT, HCPCS and UB-92 coding, UHDDS coding guidelines, AHA Coding Clinic

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.