- CVS Health (Franklin, TN)
- … medical records review. Contributes to the efficient and accurate handling of medical claims for reimbursement through knowledge of medical records ... process. Contributes to the efficient and accurate handling of medical and final expense claims for reimbursement...the scope of coverage, and policy guidelines. + Documents claim with medical records information in the… more
- CVS Health (Franklin, TN)
- …+ Assesses claims for accuracy and compliance with coding guidelines, medical necessity, and documentation requirements. + Documents claim information in the ... processing. Contributes to the efficient and accurate handling of medical claims for reimbursement through knowledge of...and guidelines. + Determines the eligibility and coverage of benefits for each claim based on the… more
- CVS Health (Franklin, TN)
- …strict adherence to policies and guidelines. + Determines the eligibility and coverage of benefits for each claim based on the patient's insurance plan and ... heart, each and every day. **Position Summary** + Performs claim documentation review, verifies policy coverage, assesses claim...be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,**… more
- Travelers Insurance Company (Franklin, TN)
- …mail and wage statements. Prints and prepares claim documents for legal and medical reviews. Reports and assigns claims , and transitions closed files to and ... professionals in multiple departments to assist with the timely resolution of claims , which may include: Properly documents claim files, including notes and… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a Claims Resolution Specialist ? At Parallon, you come first. HCA Healthcare has committed ... make a difference. We are looking for a dedicated Claims Resolution Specialist like you to be...departmental policies and procedures + Resubmit primary and secondary claims + Identify potential claim issues and… more
- Tractor Supply Company (Brentwood, TN)
- …mitigate claims expense including, but not limited to consistent medical care, minimizes overutilization, litigation costs and all other vendors are effectively ... Specialist , Workers Comp **Overall Job Summary** This position...support their well-being today and in the future. Our benefits extend beyond medical , dental, and vision… more
- Sedgwick (Nashville, TN)
- …to support the claim request and documents decision rationale. + Completes medical review of all claims by reviewing medical documentation received ... medical management of claims including comprehension of medical terminology and substantiating claim decisions. **ADDITIONAL FUNCTIONS and… more
- Elevance Health (Nashville, TN)
- …laws and contracts. Accountable for end-to-end functionality on every Coordination of Benefits (COB) function including reconciliation of claim , membership and ... **eCOB Specialist I** **Location:** Virtual, this role enables associates...medical , dental, vision, short and long term disability benefits , 401(k) +match, stock purchase plan, life insurance, wellness… more
- Elevance Health (Nashville, TN)
- …unless an accommodation is granted as required by law._ The **Excess Loss Specialist ** is responsible for working independently reviewing claims and interpreting ... **Excess Loss Specialist ** **Location :** This role enables associates to...medical , dental, vision, short and long term disability benefits , 401(k) +match, stock purchase plan, life insurance, wellness… more
- Sedgwick (Nashville, TN)
- …advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. ... Workplaces in Financial Services & Insurance (Remote) EDI Support Specialist - Casualty **PRIMARY PURPOSE** **:** To identify, research,...to include two (2) years of workers' compensation or claims related experience and three (3) years of EDI… more
- Sedgwick (Nashville, TN)
- …area of employment, ie, training or education needed, physical demands, wages and benefits , and availability. + Thoroughly reviews contested claims . + Assists as ... advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall.… more
- Datavant (Nashville, TN)
- …The Specialist is responsible for identifying, analyzing, and resolving claim denials across the entire revenue cycle to ensure optimal reimbursement and ... practices, and proficiency in multiple electronic systems and software tools. The specialist serves as a key liaison between coding, billing, utilization review,… more
- Cracker Barrel (Lebanon, TN)
- …Competitive Annual Salary | Annual Bonus Opportunities + Support That Goes Beyond the Clock: Medical , Rx, Dental and Vision Benefits on Day 1| Life Insurance and ... settlement authority up to pre-approved amounts. + Review open workers compensation claims and provide direction to our third-party administrator employees to ensure… more
- CGI Technologies and Solutions, Inc. (Nashville, TN)
- **Business Processing Specialist ** **Category:** Administration **Main location:** United States, Tennessee, Nashville **Position ID:** J0925-0220 **Employment ... the provision of affordable housing has an opening for a Business Processing Specialist in Nashville, TN. Under the direction of the Asset Manager/Central Services… more
- Sedgwick (Nashville, TN)
- …work. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Performs clinical review of referred claims ; documents decision rationale; and completes medical review of ... disability. + Provides clear and appropriate follow-up recommendations for ongoing medical management of claims ; ensures appropriate recommendations are made… more
- Kelly Services (Murfreesboro, TN)
- …Enjoy 16 paid holidays and 10-15 days of paid time off each year. + **Enhanced Medical Benefits :** Comprehensive medical coverage to keep you and your family ... **Join Our Team as an Arbitration Specialist !** Kelly Services, in partnership with Nissan North...perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical , dental, vision, telemedicine,… more
- CVS Health (Franklin, TN)
- …the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including ... leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.… more
- HCA Healthcare (Nashville, TN)
- …Submit your application for the opportunity below:Coding Account Resolution Specialist -OutpatientParallon ** Benefits ** Parallon offers a total rewards package ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more
- Kelly Services (Murfreesboro, TN)
- …Benefits Include: + 16 paid holidays + 10-15 days of paid time off + Enhanced medical benefits + Kelly Perks Discount Program + Weekly pay If you or anyone ... , perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical , dental, vision, telemedicine, term life,… more
- CDM Smith (Nashville, TN)
- …ID:** 40480BR **Business Unit:** FSU **Job Description:** The Disaster Engineering Specialist : * Conducts site inspections to validate and record infrastructure ... engineering reports, designs, and as-built plans. * Makes recommendations regarding claim eligibility. Develops or evaluates hazard mitigation proposals and … more