- HCA Healthcare (Nashville, TN)
- …recognized. Submit your application for the opportunity below:Coding Account Resolution Specialist -OutpatientParallon **Benefits** Parallon offers a total ... vary by location._** We are seeking a Coding Account Resolution Specialist -Outpatient for our team to ensure...abstracts as necessary (eg, combining the codes for outpatient claims subject to the payment window) + Assists the… more
- Travelers Insurance Company (Nashville, TN)
- …of claim and litigation strategy. + Recognize and implement alternate means of resolution . + Manages litigated claims . Develop litigation plan with staff or ... reserve, negotiate and resolve the company's most severe and/or complex claims , in multiple jurisdictions, in accordance with Best Practices. Provide quality… more
- HCA Healthcare (Hendersonville, TN)
- …and integrity. We care like family! Jump-start your career as a Medicare Specialist today with Parallon. **Benefits** Parallon offers a total rewards package that ... by location._** Come join our team as a Medicare Specialist . We care for our community! Just last year,...job specific requirements and related regulations + Reviews all claims for completeness, reasonableness of charges, and appropriateness of… more
- Molina Healthcare (Bowling Green, KY)
- JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution ... Services (CMS). **Essential Job Duties** * Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members,… more
- Sedgwick (Nashville, TN)
- …Fortune Best Workplaces in Financial Services & Insurance (Remote) EDI Support Specialist - Casualty **PRIMARY PURPOSE** **:** To identify, research, resolve, and ... internal or external customers; and assists real-time in the resolution of support issues to decrease penalty exposure. **ESSENTIAL...to include two (2) years of workers' compensation or claims related experience and three (3) years of EDI… more
- Lowe's (Nashville, TN)
- … claims . + Input and manage claims (eg, property damage) into Lowe's claims portal. + Ensure timely updates and resolution of claims to preserve ... **Your Impact** The Market Delivery Support Specialist plays a pivotal role in executing Lowe's...logistics partners, and customers, while actively managing order issues, claims , and service recovery opportunities. The Market Delivery Support… more
- Molina Healthcare (Bowling Green, KY)
- JOB DESCRIPTION Provides support for claims activities including reviewing and resolving **Provider No Surprises Act** cases in accordance with the standards and ... (CMS). **Essential Job Duties** * Responsible for the comprehensive research and resolution of **Provider No Surprises Act** cases to ensure that internal and/or… more
- Molina Healthcare (Bowling Green, KY)
- …for reviewing and resolving member and provider complaints and communicating resolution to members and provider (or authorized representatives) in accordance with ... Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution of the appeals, dispute, grievances, and/or complaints from… more
- Datavant (Nashville, TN)
- …and life experiences to realize our bold vision for healthcare. The Specialist is responsible for identifying, analyzing, and resolving claim denials across the ... proficiency in multiple electronic systems and software tools. The specialist serves as a key liaison between coding, billing,...coding experience, with a focus on denial review and resolution **You will:** + Monitor and manage denials throughout… more
- Molina Healthcare (Bowling Green, KY)
- …clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains ... audits and communicates with Core Operations Functional Business Partners to ensure resolution within 30 days of error issuance. * Evaluates the adjudication of… more
- Deloitte (Nashville, TN)
- …wants to work in a collaborative environment? As an experienced Epic Professional Billing Specialist , you will have the ability to share new ideas and collaborate on ... service delivery. Work you'll do/Responsibilities As a Project Delivery Specialist (PDS) at Deloitte, you will work within an...Assign and prioritize work across shores to ensure timely resolution of tickets + Coordinate with the offshore team… more
- Molina Healthcare (Bowling Green, KY)
- …for reviewing and resolving member & provider complaints and communicating resolution to members (or authorized) representatives in accordance with the standards ... and grievances. + Elevates appropriate appeals to the Appeals Specialist . + Generates and mails denial letters. + Assists...**C** **E:** + 1 year of Molina experience, health claims experience, OR one year of customer service/provider service… more
- Deloitte (Nashville, TN)
- …wants to work in a collaborative environment? As an experienced Epic Professional Billing Specialist you will have the ability to share new ideas and collaborate on ... East Coast working Eastern Time zone hours. + Provide support for incident resolution + Provide support for service requests + Provide support for enhancement build… more
- Western Digital (Nashville, TN)
- …**Job Description** **Position Summary** We are looking for a **Retail Compliance Specialist ** to join the Western Digital Fulfillment Operations Team to be ... chargebacks, late deliveries, labeling errors, incorrect shipments. Review and validate claims received from retail partners to determine legitimacy and compliance… more
- Molina Healthcare (Bowling Green, KY)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... and finance partners to proactively identify issues and implement resolution strategies. + Serves as a thought partner to...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… more
- HCA Healthcare (Nashville, TN)
- …areas predominately post initial/final coding. You will also perform the alert/edit resolution activities in the applicable systems. The alerts/edits shall be worked ... or must be rerouted to another responsible party for research/ resolution + Escalates alert/edit resolution issues as...abstracts as necessary (eg, combining the codes for outpatient claims subject to the payment window) + Assists the… more
- Cardinal Health (Nashville, TN)
- …authorization through billing and collections. Job Purpose: The Patient AR Specialist is responsible for managing and resolving outstanding patient balances, ... cycle process. This includes, billing follow up, collections, payment posting, denial resolution , and responding to patient inquiries in a professional and timely… more
- BrightSpring Health Services (Nashville, TN)
- …report out. + Complete follow up process to ensure full adjudication of claims . + Identifies adjustments throughout the month for assigned Operations. + Timely ... exceptions, or exclusions. + Maintain open communication with Billing Specialist , Cash Application Analyst and Operations. + Send cash...+ Works in Waystar to identify denials and timely resolution . + Timely follow up of accounts to ensure… more
- Prime Therapeutics (Nashville, TN)
- …The Sr Health Plan Account Manager serves as a line of business specialist for their assigned account/s and provides information, analyses, and consulting to the ... in the market. **Responsibilities** * Serve as a line of business specialist responsible for managing client relationships within assigned health plan/s; effectively… more