- Highmark Health (Nashville, TN)
- …charges. The incumbent will also conduct or assist with provider and subscriber investigations to verify the validity of services and charges; will monitor internal ... facility and professional provider over-payments. + Investigation Support: Assist with investigations : Assist in the interviews of customers and providers to obtain… more
- Cardinal Health (Nashville, TN)
- …+ Experience conducting and documenting patient health insurance benefit investigations , prior authorizations, and appeals, preferred (2+ years) + Knowledge ... of Medicare, Medicaid and Commercially insured payer common practices and policies, preferred + Critical and creative thinking, preferred + Knowledge of Medical/Pharmacy billing and coding, preferred + Strong attention to detail is vital + Bilingual, preferred… more
- Cardinal Health (Nashville, TN)
- …of applicable regulations, standards, and operating procedures. + Conduct investigations /root cause analysis and formulate corrective action recommendations. + Show ... an understanding of the program requirements and be capable of conducting gap assessments based on those requirements. + Uphold quality standards that adhere to company, regulatory, and HIPAA policies and procedures. + Collaborate across various functions,… more
- Cardinal Health (Nashville, TN)
- …regulations, standards, and operating procedures. + Demonstrates ability to perform investigations / root cause analysis and develop corrective actions. + ... Demonstrates an understanding of the requirements and has the ability to perform gap assessments to those requirements. + Demonstrates an understanding of quality concepts such as: cost of quality, analytical metrics and / or statistics, trending, quality… more
- Kiewit (Cumberland City, TN)
- …with emergency medical services and clinics * Assist with incident investigations , and implementation of effective solution * Complete a daily documented ... environment Other common names for this role: Project Safety Coordinator , Onsite Safety Coordinator , Field Safety ...this role: Project Safety Coordinator , Onsite Safety Coordinator , Field Safety Coordinator , "Environmental, Health &… more
- Metro Nashville Government (Nashville, TN)
- …for MPHD, which includes certifying records, serving as the public records coordinator , processing records responsive to public record requests, (PRR), and ensuring ... Rights, other legal entities, and organization officers in any compliance reviews or investigations . + Works with the ELT, legal counsel, MPHD's HIPAA Privacy and… more