Clinical Reviewer - FEP
Blue Cross Blue Shield of MassachusettsHighlight
Summary
About the Role
About You
- Active licensure in Massachusetts.
- Current certification in coding from a recognized organization (e.g., AAPC or AHIMA).
- In-depth knowledge of HCPCS, CPT, ICD10-CM diagnosis and procedure codes.
- Bachelor of Science in Nursing (BSN) degree.
- 3-5 years of clinical experience.
- Utilization management experience.
- FEP experience.
Benefits
- Paid time off.
- Medical/dental/vision insurance.
- 401(k) plan.
- Suite of well-being benefits.
Blue Cross Blue Shield of Massachusetts is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We have been a market leader for over 80 years, and are consistently ranked among the nation's best health plans. Our daily efforts are dedicated to effectively serving our 3 million members, and consistently offering security, stability, and peace of mind to both our members and associates. As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. We are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path. We take pride in our diverse, community-centric, wellness-focused culture and believe every member of our team deserves to enjoy a positive work-life balance. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Blue Cross Blue Shield of Massachusetts complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation or gender identity. ATTENTION: If you don’t speak English, language assistance services, free of charge, are available to you. Call Member Services at the number on your ID Card (TTY: 711). ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia con el idioma. Llame al número de Servicio al Cliente que figura en su tarjeta de identificación (TTY: 711). ATENÇÃO: Se fala português, são-lhe disponibilizados gratuitamente serviços de assistência de idiomas. Telefone para os Serviços aos Membros, através do número no seu cartão ID (TTY: 711).