- CVS Health (Franklin, TN)
- …effective communication skills. **Job Description Summary** + Handles and processes Benefits claims submitted by healthcare providers, ensuring accuracy, ... healthcare providers and policyholders, and ensures accurate and timely claims processing. Contributes to the efficient and accurate handling...and guidelines. + Determines the eligibility and coverage of benefits for each claim based on the… more
- Travelers Insurance Company (Franklin, TN)
- … professionals in multiple departments to assist with the timely resolution of claims , which may include: Properly documents claim files, including notes and ... level included in this posting. To learn more about our comprehensive benefit programs please visit http://careers.travelers.com/life-at-travelers/ benefits / . more
- Community Health Systems (Antioch, TN)
- …of account activity, and adherence to applicable regulations to support revenue cycle operations . As a Collections Specialist II at Community Health Systems ... **Job Summary** The Collections Specialist I - HMO/PPO is responsible for performing...operations required + Experience working with insurance follow-up, claim resolution, and payer communication in a healthcare setting… more
- Tractor Supply Company (Brentwood, TN)
- … claim management strategy in coordination with Return-to-Work Program for operations in multi-states. + Supports Critical Claim Decision Points (Reserving, ... Specialist , Workers Comp **Overall Job Summary** This position...(TPA) Programs including: + Contract terms & costs, + Claim handling specifications, and + Achievement of outcome metrics.… more
- Prime Therapeutics (Nashville, TN)
- …and procedures. Responsibilities include answering incoming calls related to eligibility, benefits , claims and authorization of services from members or ... calls. + Researches and articulately communicates information regarding member eligibility, benefits , EAP services, claim status, and authorization inquiries to… more
- Sedgwick (Nashville, TN)
- …advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. ... Fortune Best Workplaces in Financial Services & Insurance (Remote) EDI Support Specialist - Casualty **PRIMARY PURPOSE** **:** To identify, research, resolve, and… more
- CVS Health (Franklin, TN)
- …measuring and monitoring the quality and effectiveness of work processes in claim processing and/or customer service that impact customer satisfaction, medical cost ... outcomes. + Monitors internal teams and assists with the daily maintenance and operations of business units. + Observes team operations and identifies… more
- Prime Therapeutics (Nashville, TN)
- …every decision we make. **Job Posting Title** Medication Therapy Management Specialist **Job Description** The Medication Therapy Management (MTM) Service ... Specialist is responsible for receiving inbound and making outbound...members across all lines of business to review the benefits of the MTM program. This position speaks with… more
- Western Digital (Nashville, TN)
- …data. **Job Description** **Position Summary** We are looking for a **Retail Compliance Specialist ** to join the Western Digital Fulfillment Operations Team to ... chargebacks, late deliveries, labeling errors, incorrect shipments. Review and validate claims received from retail partners to determine legitimacy and compliance… more
- Walgreens (Nashville, TN)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... (eg, offering help proactively, identifying needs, servicing until satisfied, etc.). ** Operations ** + Executes and coaches team members on warehouse and vendor… more
- Philips (Nashville, TN)
- escription **Order Management Specialist ** As an Order Management Specialist you are responsible for implementing sales orders diligently to ensure timely ... oversight of order fulfillment, including processing returns, to maintain seamless operations across various sales channels, quickly addressing any deviations or… more
- Cardinal Health (Nashville, TN)
- …management methodology and requirements gathering is a plus. + Basic understanding of operations and claims processing in pharmacy or other healthcare related ... to meet and exceed revenue and profitability objectives. The _Sr. Specialist , Business Intelligence_ provides Product & Solutions Marketing support to internal… more
- Sevita (Nashville, TN)
- …day. Join us today, and experience a career well lived. **Accounts Receivable Specialist ** **Not a Remote Position** **Hourly Rate $21.50** **Full Benefits with ... Finance group is essential. + Maintain an effective control environment under accounting operations . Includes both key and non-key controls and extends to the timely… more
- GAP Solutions Inc (Nashville, TN)
- **Position Objective:** As a Junior Human Resource Specialist , apply HR skills in support of managers, program staff and customers on the full range of HR topics ... including but not limited to staffing, classification, processing, benefits , recruitment, compensation, SES programs, work life programs, policy and employee and… more
- Vanderbilt University Medical Center (Nashville, TN)
- …account inquiries and payer denials. . KEY RESPONSIBILITIES * Processes claims , payments, adjustments, refunds, denials, and unpaid patient and insurance balances. ... employees stay at Vanderbilt Health for professional growth, appreciation of benefits , and a sense of community and purpose. **Core Accountabilities:** *… more
- BrightSpring Health Services (Nashville, TN)
- …adjudication of claims . + Identifies adjustments throughout the month for assigned Operations . + Timely follow up on insurance claim denials, exceptions, or ... exclusions. + Maintain open communication with Billing Specialist , Cash Application Analyst and Operations . +...cash team. + Reading and interpreting insurance explanation of benefits . + Respond to inquiries from insurance companies, patients,… more
- Cardinal Health (Nashville, TN)
- **_What Revenue Cycle Management (RCM) contributes to Cardinal Health_** Practice Operations Management oversees the business and administrative operations of a ... authorization through billing and collections. Job Purpose: The Patient AR Specialist is responsible for managing and resolving outstanding patient balances,… more
- Cardinal Health (Nashville, TN)
- …Health_** Practice Operations Management oversees the business and administrative operations of a medical practice. Benefits Eligibility and Authorization ... insurance companies, on behalf of the physician's office, to verify patient specific benefits . The Benefits Verification Specialist will ask appropriate… more