- HCA Healthcare (Nashville, TN)
- …**Introduction** Do you want to join an organization that invests in you as a Medicare Specialist ? At Parallon, you come first. HCA Healthcare has committed up ... make a difference. We are looking for a dedicated Medicare Specialist like you to be a...you will do in this role: + Reviews all claims for completeness, reasonableness of charges and appropriateness of… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Billing Specialist I - Payment Compliance is responsible for processing, auditing, and submitting primary and secondary insurance claims , ... ensuring accuracy, compliance, and timely reimbursement. This role utilizes electronic claims management systems to review, correct, and resolve billing errors,… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Utilization Management Specialist , Revenue Integrity and Utilization Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health ... Forbes "Best Employer" seven times. Position Summary: The Utilization Management Specialist I will perform utilization management functions to include medical… more
- Cardinal Health (Nashville, TN)
- …ensures accurate documentation, timely follow-up, and proper submission of appeals or corrected claims to reduce revenue loss. The specialist works closely with ... the patient's account balance is zero. **_Job Summary_** The Authorization Denial Specialist is responsible for reviewing and resolving claim denials related to… more
- Intermountain Health (Nashville, TN)
- **Job Description:** Responsible for the timely follow-up of claims billed and resolution of accounts. Oversees the account receivables and maintains ... detailed/accurate account documentation. Follow up on open claims thoroughly, accurately, promptly, and with all supporting documentation. Responsible for… more
- Diversicare Healthcare Services & Diversicare Ther (Brentwood, TN)
- …recovery. You'll be responsible for: + Creating and filing all Managed Care, Medicare , and PVI claims . + Systematically and timely resolving all accounts, ... Difference: Join Our Team as a Skilled Care Billing Specialist !** Are you a detail-oriented professional with a passion...is required. + Experience with SNF Managed Care and Medicare , along with Point Click Care (PCC), is highly… more
- Cardinal Health (Nashville, TN)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. ... and support from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves by follow-up &… more
- Banner Health (TN)
- …knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group (APR-DRG) and Ambulatory Payment ... coding expertise to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim denials utilizing multiple… more
- HCA Healthcare (Nashville, TN)
- …Description Works with team members in billing, revenue integrity and/or the Medicare Service Center to resolve alerts/edits Communicates coding revisions to the ... log) Completes MOCK abstracts as necessary (eg, combining the codes for outpatient claims subject to the payment window) Assists the Coding Leads and/or Coding… more
- HCA Healthcare (Nashville, TN)
- …leadership + Works with team members in billing, revenue integrity and/or the Medicare Service Center to resolve alerts/edits + Communicates coding revisions to the ... abstracts as necessary (eg, combining the codes for outpatient claims subject to the payment window) + Assists the...needed, may periodically be asked to perform Coding Integrity Specialist II (CIS-II) duties + Periodically works with their… more
- Highmark Health (Nashville, TN)
- …system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare ... or Outpatient): Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) + AAPC Credentials (Outpatient): Certified Professional Coder… more