About Our Company

Cahaba Safeguard Administrators, LLC is a wholly owned subsidiary of Blue Cross and Blue Shield of Alabama that was created to administer the provisions of any task orders under the Medicare contract.

Department Overview

General Responsibilities

Note:  This position may be filled at a higher level based on experience.

This position is responsible for conducting medical review activities related to benefit integrity for Medicare Part A, Part B, Part C, Home Health and Hospice claims utilizing professional medical knowledge to determine the appropriateness of payment for medical services according to the Social Security Act; Codes of Federal Regulations; National Coverage Determinations; Local Coverage Determinations; Medicare/Medicaid coverage eligibility and reimbursement requirements.  The incumbent will coordinate resolutions of program integrity cases within CSA's other departments, law enforcement agencies, CMS, QIO and AC/MAC, Medicaid, Medicare Fair Hearings, Administrative Law Judge (ALJ), etc.

Qualifications

1.  Bachelor's degree or, upon hire commit to actively pursue a degree
2.  Active license as a Registered Nurse
3.  Upon hire, willingness and ability to obtain an active RN license in the state of contract award
4.  Minimum of 5 years clinical experience as an RN
5.  Experience in a position communicating and interpreting information orally and written
6.  Experience in a position exercising independent judgment and decision making
7.  Experience in a position analyzing information to solve problems
8.  Knowledge of Medicare regulations and procedures
9.  Proficient in using a PC and keyboard in a Windows environment
10.  Ability to travel up to 40% of the time
11.  Experience working with ICD-9-CM/CPT-4 coding, preferred
12.  Experience in a position working with Medicare Part A, Part B, DME, and home health/hospice, preferred
13.  Experience with utilization/medical review is a plus

Work Schedule

The hours for this position are 8:00 a.m. to 4:45 p.m.

Conditions of Employment

Applicants selected for employment will be required to pass a pre-employment drug screening and background investigation which may include education, criminal, and work history verifications.

How To Apply

Information about current career opportunities can be found on our web site at www.bcbsal.jobs .  Click on Search All CSA Jobs.

To apply, build a profile online and attach your resume by registering with our website.  Click on the "Apply Now" button to login or register if this is your first time.

In Conclusion

Thank you for your interest in Cahaba Safeguard Administrators, LLC.  We look forward to receiving your application.  Upon review, if you can be considered further you will be contacted by one of our Human Resources representatives.

Again, thank you for your interest in our company.

Cahaba Safeguard Administrators, LLC is an affirmative action and equal opportunity employer.  As such, it is our policy to provide equal opportunity for all qualified persons and not discriminate against any associate or applicant for employment because of race, religion, color, sex, sexual orientation, age, national origin, handicap, disability, genetics, or  because he or she is a disabled veteran or a Vietnam Era Veteran.