- HCA Healthcare (Nashville, TN)
- …**_Note: Eligibility for benefits may vary by location._** We are seeking a Medicare Specialist for our team to ensure that we continue to ... we do. We want you to apply! **Job Summary and Qualifications** Seeking a Medicare Specialist , who will be responsible for all aspects of Medicare receivable… more
- Vanderbilt University Medical Center (Nashville, TN)
- …Payor/Provider Enrollment **Job Summary:** JOB SUMMARY A payor enrollment specialist is responsible for tracking the process of enrolling healthcare ... providers with insurance payors or health plans. This typically involves completing and submitting applications, verifying credentials, ensuring compliance with payor requirements, and maintaining accurate records. They may also handle provider updates,… more
- Prime Therapeutics (Nashville, TN)
- …our passion and drives every decision we make. **Job Posting Title** MTM Specialist Sr **Job Description** The Senior Medication Therapy Management (MTM) Service ... Specialist will act as a Subject Matter Expert for...meets the specialized needs of the targeted population; for Medicare , is Centers for Medicare & Medicaid… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Physician Education Specialist provides training and education to CHS-affiliated providers and staff on accurate coding and documentation to ... management services, procedures, and other physician work in compliance with Medicare , Medicaid, and other payer requirements. + Identifies and communicates… more
- HCA Healthcare (Nashville, TN)
- …We care like family! Jump-start your career as an Inpatient Coding Specialist today with Parallon. **Benefits** Parallon, offers a total rewards package that ... Come join our team as an Inpatient Coding Resolution Specialist . We care for our community! Just last year,...with team members in billing, revenue integrity and/or the Medicare Service Center to resolve alerts/edits + Assigns interim… more
- HCA Healthcare (Nashville, TN)
- …We care like family! Jump-start your career as a(an) Collections Specialist today with Premier Ambulatory Surgery Center. **Benefits** Premier Ambulatory Surgery ... by location._** Come join our team as a(an) Collections Specialist . We care for our community! Just last year,...and administer contracts in collection of third party accounts ( Medicare and Medicaid) + You will complete account reconciliation… more
- Community Health Systems (Antioch, TN)
- **Job Summary** The Billing Specialist I is responsible for processing, auditing, and submitting primary and secondary insurance claims, ensuring accuracy, ... review, correct, and resolve billing errors, denials, and rejections. The Billing Specialist I collaborates with internal teams, facility liaisons, and payers to… more
- J&J Family of Companies (Nashville, TN)
- …**Job Description:** We are searching for the best talent for Area Business Specialist to be in Nashville TN. **About Immunology** Our expertise in Innovative ... of the way. Learn more at https://www.jnj.com/innovative-medicine As the Area Business Specialist (ABS), you will: + Ensure appropriate identified new and existing… more
- CVS Health (Nashville, TN)
- …day. **Position Summary** In this position, the senior Claim Benefit Specialist (OPS) reviews, researches and adjudicates complex, sensitive, and/or specialized ... years Medical Claims processing experience adjudicating claims (Commercial, Medicaid, Medicare , etc.) -Experience in a production environment. -Analytical skills,… more
- Cardinal Health (Nashville, TN)
- …a call center or customer service environment, preferred + Clear knowledge of Medicare , Medicaid & Commercial payer policies and guidelines for coverage, preferred + ... Knowledge of Diagnostic Medical Expense and Medicare Administrative Contractor practices, preferred + Clear understanding of Medical, Supplemental, and pharmacy… more
- CVS Health (Franklin, TN)
- …communication skills are essential, both internal and external. + Knowledge of Medicare benefits, enrollments and LIS assistance. + Plans and organizes work ... assignments, set priorities and completes work with a minimum of supervision. + Adheres to the service policy and principles of the company, as well as the program guidelines set by the department. + Participates in cross-training to perform all roles within… more
- CenterWell (Nashville, TN)
- …has a strong emphasis on senior-focused primary care for members of Medicare Advantage health plans and is committed to providing personalized, high-quality primary ... Identify and act on opportunities to better manage & coordinate with high-quality specialist , hospital, and community partners to serve patient needs and deepen our… more
- CenterWell (Hermitage, TN)
- …advanced practice professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist , Quality based Coder, Referral Coordinator and more. Our approach allows ... for TB. Preferred Qualifications: + Active and unrestricted DEA license + Medicare Provider Number/ Medicaid Provider Number + Experience managing Medicare … more
- CenterWell (Madison, TN)
- …advanced practice professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist , Quality based Coder, Referral Coordinator and more. Our approach allows ... for TB. Preferred Qualifications: + Active and unrestricted DEA license + Medicare Provider Number/ Medicaid Provider Number + Experience managing Medicare … more
- Evolent (Nashville, TN)
- …Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or… 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 ... Reasons + As needed, may periodically be asked to perform Coding Integrity Specialist II (CIS-II) duties + Periodically works with their Manager to review individual… 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
- HCA Healthcare (Nashville, TN)
- …Commission (TJC)/Accreditation Association for Ambulatory Health Care (AAAHC), Centers for Medicare and Medicaid Services (CMS), state survey agencies, etc. * ... experience and success) * Registered nurse, registered pharmacist, a laboratory specialist to include a medical technologist licensed as a medical technologist… more
- HCA Healthcare (Nashville, TN)
- …leadership + Work with team members in billing, revenue integrity and/or the Medicare Service Center to resolve alerts/edits + Communicate coding revisions to the ... Reasons + As needed, may periodically be asked to perform Coding Integrity Specialist II (CIS-II) duties + Periodically works with their Manager to review individual… more