ZipRecruiter

Log In

2

Blue Cross Rn Remote Jobs in Tennessee (NOW HIRING)

Vertek Staffing

CDI Specialist

Franklin, TN · Remote

$33.50 - $45/hr

CDI Specialist - Remote Acute Care Hospital Experience Required Required Education * High School ... Required: * Active, unrestricted Registered Nurse (RN) license Preferred Certifications:

Monogram Health

Market Physician Executive

Memphis, TN · Remote

Review and approve APP, RN, SW, and PharmD plans of care. * Appropriate and timely patient document ... This position will be remote within the designated market with occasional in-home patient treatment ...

Monogram Health

Market Physician Executive

Nashville, TN · Remote

Review and approve APP, RN, SW, and PharmD plans of care. * Appropriate and timely patient document ... This position will be remote within the designated market with occasional in-home patient treatment ...

next page

Showing results 1-20

All JobsBlue Cross Rn JobsBlue Cross Rn Remote JobsBlue Cross Rn Remote Jobs in Tennessee

Blue Cross Rn Remote information

What are the key skills and qualifications needed to thrive as a Blue Cross RN Remote, and why are they important?

To excel as a Blue Cross RN Remote, you need an active RN license, clinical nursing experience (often in case management or utilization review), and strong assessment abilities. Familiarity with electronic medical record (EMR) systems, telehealth platforms, and case management software is typically required, along with certifications like CCM (Certified Case Manager) being advantageous. Exceptional communication, self-motivation, and organizational skills help nurses effectively support members and collaborate virtually with healthcare teams. These competencies ensure quality patient care, regulatory compliance, and efficient service delivery in a remote environment.

What is the difference between Blue Cross Rn Remote vs Blue Cross Lpn Remote?

AspectBlue Cross Rn RemoteBlue Cross Lpn Remote
Required CredentialsRegistered Nurse (RN) licenseLicensed Practical Nurse (LPN) license
Work EnvironmentRemote healthcare support, patient assessmentsRemote patient care, basic clinical tasks
Employer & Industry UsageHealth insurance companies, healthcare providersHealth insurance companies, healthcare providers
Common Search & ComparisonYesYes

Blue Cross Rn Remote and Blue Cross Lpn Remote roles both serve in remote healthcare settings within insurance companies and healthcare providers. The main difference lies in the required credentials: RNs need a registered nurse license, while LPNs require a practical nurse license. RNs typically handle more complex patient assessments, whereas LPNs focus on basic patient care tasks. Both roles are essential in remote healthcare support, but they differ in scope and qualification requirements.

What is a Blue Cross RN Remote?

A Blue Cross RN Remote is a registered nurse who works remotely for Blue Cross Blue Shield, typically supporting members through telehealth, case management, care coordination, and health coaching. These nurses use phone, video calls, and digital platforms to assess patient needs, develop care plans, and provide education and support. Their role helps ensure that members receive high-quality care and guidance without needing in-person visits, making healthcare more accessible and convenient. Blue Cross RNs working remotely may also assist with pre-authorization, utilization management, or disease management programs.

How does a remote Blue Cross RN typically communicate and coordinate care with interdisciplinary team members?

As a remote Blue Cross RN, effective communication with physicians, case managers, social workers, and other healthcare professionals is essential. Most coordination occurs via secure digital platforms, video calls, and phone conferences, allowing for timely updates on patient progress and care plans. Regular virtual meetings and documentation in shared electronic health records ensure seamless teamwork and continuity of care. Building strong digital communication skills and being proactive about follow-ups are key to success in this remote setting.
What are popular job titles related to Blue Cross Rn Remote jobs in Tennessee? For Blue Cross Rn Remote jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Blue Cross Rn Remote jobs in Tennessee look for? The top searched job categories for Blue Cross Rn Remote jobs in Tennessee are:
What cities in Tennessee are hiring for Blue Cross Rn Remote jobs? Cities in Tennessee with the most Blue Cross Rn Remote job openings:
Blue Cross Rn Remote jobs near you
Infographic showing various Blue Cross Rn Remote job openings in Tennessee as of July 2026, with employment types broken down into 77% Full Time, 14% Part Time, and 9% Contract. Highlights an 100% Remote job distribution.
CDI Specialist

CDI Specialist

Vertek Staffing

Franklin, TN • Remote

$33.50 - $45/hr

Contractor

Posted 18 days ago

Job description

CDI Specialist - Remote

Acute Care Hospital Experience Required

Required Education
  • High School Diploma required with submission
Required Certifications & Licensure

Online certification verification required with submission.

Required:

  • Active, unrestricted Registered Nurse (RN) license

Preferred Certifications:

  • Certified Clinical Documentation Specialist (CCDS) - ACDIS
  • Certified Documentation Improvement Practitioner (CDIP) - AHIMA
  • Certified Coding Specialist (CCS) - AHIMA
  • Registered Health Information Administrator (RHIA) - AHIMA
  • Registered Health Information Technician (RHIT) - AHIMA
Schedule
  • Monday - Friday
  • Occasional weekend coverage may be required based on client needs
Position Summary

The CDI Specialist is responsible for improving the overall quality and completeness of clinical documentation within the medical record. Through concurrent review of patient records, the CDI Specialist collaborates with physicians, nursing staff, coding professionals, case management, and other healthcare team members to ensure documentation accurately reflects severity of illness, risk of mortality, quality measures, and resource utilization.

The CDI Specialist identifies opportunities for documentation clarification through compliant physician queries and helps ensure documentation supports accurate coding, reimbursement, quality reporting, and denial prevention.

This role requires strong clinical knowledge, critical thinking skills, and a thorough understanding of ICD-10-CM/PCS coding guidelines, MS-DRG assignment, APR-DRG methodologies, and regulatory requirements.

The CDI Specialist will work collaboratively with HIM, Coding, Case Management, Utilization Review, Physician Advisors, and providers to support accurate and complete clinical documentation.

Key Responsibilities
  • Conduct concurrent reviews of inpatient medical records to identify documentation improvement opportunities.
  • Initiate compliant physician queries to clarify diagnoses, procedures, severity of illness, risk of mortality, and present-on-admission indicators.
  • Collaborate with Coding, HIM, Case Management, Utilization Review, and clinical teams to promote complete and accurate documentation.
  • Ensure documentation supports appropriate MS-DRG and APR-DRG assignment.
  • Assist with reducing denials through accurate clinical documentation and physician education.
  • Monitor documentation trends and identify opportunities for process improvement.
  • Participate in physician education initiatives related to documentation best practices.
  • Maintain productivity and quality standards established by the client.
  • Stay current on regulatory requirements, coding guidelines, and CDI best practices.
  • Assist leadership with special projects and additional duties as assigned.
Required Experience
  • Active RN license
  • Acute Care Hospital CDI experience required
  • Experience performing concurrent inpatient chart reviews
  • Experience writing compliant physician queries
  • Strong understanding of clinical documentation improvement principles
  • Knowledge of MS-DRGs, APR-DRGs, Severity of Illness (SOI), and Risk of Mortality (ROM)
  • Experience collaborating with physicians and interdisciplinary teams
Preferred Experience
  • CCDS and/or CDIP certification
  • Strong understanding of ICD-10-CM/PCS coding guidelines
  • Experience with mortality reviews, quality initiatives, and denial prevention
  • Experience with Epic, Cerner, Meditech, or other major EMR systems
 
Vertek Solutions logo

About Vertek Solutions

Sourced by ZipRecruiter

Vertek Solutions is a boutique staffing firm that specializes in recruiting top level IT talent who can enhance our clients’ teams. Our team works every day to foster relationships with both our consultants and clients to understand their needs and ensure that we are providing a solution that is mutually beneficial.

Industry

Recruiting and staffing services

Company size

11 - 50 Employees

Headquarters location

Franklin, TN, US

Year founded

2006

Social media

FacebookInstagram

View All Vertek Solutions Jobs

Apply