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I am not a nurse for BCBS, but I've worked there for 5 years. Keep in mind that every BCBS is different. But there are two main types of BCBS nurses that I am aware of...
mainly, experienced nurses review medical records to determine if certain admissions and individual procedures (prior and post admission/testing/etc.) are medically necessary or covered under the member's policy. From the job postings I've seen at my BCBS (every BCBS is different!), nurses work normal business hours; I've seen a few work solely from home (though the ones I've seen offered this luxury are NPs)
additionally, there are nurses that man the help lines. Customers with BCBS insurance call a 24/hr hotline where a nurse can give medical advice over the phone (fevers, coughs, flu, go to the ER, etc. usually this position has lower pay than the above). Hope an actual BCBS nurse can comment and give you more information, but I hope this was helpful anyway. :)
I quit BCBS on the spot, after I figured out the "help line" was really a spy line. Actually we were trying to glean info from members regarding their future plans for surgery,etc.
The corporate mentality and pecking order was brutal.
They have a hard time filling positions, that should speak volumes.
Sl1011
402 Posts
Are there any nurses on here that work for Blue Cross Blue Shield? If so, would you mind posting what your job duties are (title too) and how you came across the job? How much experience did you need? What are your hours? Did you take a pay cut?
There's a possibility for a position in my area, and I was just curious about what a nurse does at BCBS. Thanks!!!