- Lincoln Financial (Nashville, TN)
- …**Requisition #:** 74647 **The Role at a Glance** We are excited to bring on a Claims Customer Care Associate to join our claimant excellence team supporting ... coaching and development to perform in this fast-paced environment. As a Claims Customer Care Associate , you will be responsible for answering claimants… more
- Amrize (Nashville, TN)
- Warranty Claims Estimator Requisition ID: 14853 Location: Nashville, TN, US, 37214 Pay Type: **COMPANY OVERVIEW** Amrize is building North America. From bridges and ... important asset - our employees. We're seeking a Warranty Claims Estimator who's ready to be part of our...FOR** A bachelor's degree or a combination of an associate degree, previous industry-related work experience, and licensure or… more
- Zurich NA (Nashville, TN)
- …you. Overview: + Monitor business processes to identify opportunities for customer care 's improvements. + Handle first and third-party claims taking ... Auto Claims Call Center Senior Represent 127692 Zurich is...area OR + Zurich Certified Insurance Apprentice including an Associate Degree and No prior experience required in the… more
- Humana (Nashville, TN)
- …and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs ... of decisions to internal associates, and possible participation in care management. May occasionally participate in discussions with external physicians… more
- Evolent (Nashville, TN)
- …a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to ... a mission with a company behind it. **What You'll Be Doing:** ** Associate Director, Performance Analytics - Oncology & Member Product Focus** **Overview:** Evolent… more
- Evolent (Nashville, TN)
- …people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care ... system and ensure people get the same level of care and compassion we would want for our loved...our specialty programs and administrative platform. Role Overview The Associate Director role on Client Analytics will support both… more
- Walgreens (Nashville, TN)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Walmart (Murfreesboro, TN)
- …Floor in accordance with Company policies and procedures by properly handling claims and returns, zoning the area, arranging and organizing merchandise, and ... digital tools to drive sales, improve the shopping experience, and elevate associate engagement; utilizing hand held technology to make immediate business decisions… more
- Lowe's (Nashville, TN)
- **Your Impact at Lowe's** As a Market Delivery Associate , you'll be collaborating with team members in-office to solve logistic challenges and deliver an exceptional ... order management systems. + Manage customer escalated issues and Executive Care opportunities for immediate resolutions. + Collaborate with third-party logistics… more
- Walmart (Murfreesboro, TN)
- …thinking You will make an impact by: * Ensuring high-quality products are taken care of and available for our members * Ensuring shelves are clean, maintaining ... area in accordance with Company policies and procedures by properly handling claims and returns; zoning the area; receiving and stocking merchandise; setting up,… more
- Intermountain Health (Nashville, TN)
- **Job Description:** Provides extraordinary care to our customers through friendly, courteous, and professional service through a broad understanding of account ... + Perform other duties as assigned **Skills** + Insurance Claims + Medical Billing + Explanation of Benefits (EOB)...hourly rate dependent upon experience. $18.81 - $27.45 We care about your well-being - mind, body, and spirit… more
- Sedgwick (Nashville, TN)
- …claim adjustments, provider requests and operational expense check requests. + Queues claims for Managed Care ; transfers payment allocations; and runs manual ... required. Associate degree preferred. **Experience** Two (2) years of claims management or insurance experience or equivalent combination of education and… more
- Humana (Nashville, TN)
- …**Required Qualifications** + Three or more years work experience reading and interpreting claims within a managed care /health care environment + Familiarity ... anomalies in data to identify and collect overpayment of claims . Contributes to the investigations of fraud waste and...are Monday-Friday, 8 hours/day, and 5 days/week in the associate 's home time zone. Some schedule changes/adjustments might be… more
- Humana (Nashville, TN)
- …community and help us put health first** Design and maintain Medicaid claims analytics dataset using Databricks. Conduct in-depth analysis of healthcare claims ... Identify cost drivers, utilization patterns, and anomalies in Medicaid medical claims data. Maintain dashboards to communicate key trends to stakeholders. The… more
- Community Health Systems (Franklin, TN)
- …The Denial Coordinator is responsible for reviewing, tracking, and resolving denied claims , ensuring that appropriate appeals are submitted, and working closely with ... critical part in the denials management process, supporting efforts to improve claims resolution, reduce future denials, and ensure compliance with payer guidelines.… more
- Humana (Nashville, TN)
- …looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and ... provider contract payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments. Analyzes, enters… more
- AO Smith (Lebanon, TN)
- …provide clear guidance on company policies, processes and procedures. + Negotiate validated labor claims with Reps & non-CSP's + Travel 80% in order to support and ... and sales departments of status and disposition of customer complaints and claims . + Utilize interpersonal skills to communicate professionally at all levels within… more
- Humana (Nashville, TN)
- …responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and expansion into new ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
- Humana (Nashville, TN)
- …achieving operational and compliance key performance indicators. In addition, the associate will participate in cross functional teams and support analyzing business ... an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing and… more
- Humana (Nashville, TN)
- …have expertise in conducting retrospective observational studies using administrative claims data using a collaborative approach across multiple stakeholders. Humana ... + An understanding of research methodology and the managed care arena, and how it applies to health outcomes...with cloud base analytics platforms + Experience with clinical, claims , pharmacy or other healthcare data. + Strategic thinking… more