- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Supervisor , Claims Review makes appropriate claim decision based on strong ... procedures, contract provisions, and state and federal legislation. The Supervisor , Claims Review works within thorough, prescribed guidelines and… more
- Sedgwick (Nashville, TN)
- …equivalent combination of education and experience required to include two (2) years claims supervisor experience. **Skills & Knowledge** + Thorough knowledge of ... management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and… more
- Ryder System (Nashville, TN)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling processes… more
- Cardinal Health (Nashville, TN)
- …Collections is responsible for the timely follow-up and resolution of insurance claims . This role ensures accurate and efficient collection of outstanding balances ... receivable and increase cash flow for the organization. **_Responsibilities:_** + Review aging reports and work insurance accounts to ensure timely resolution… more
- HCA Healthcare (Hendersonville, TN)
- …operations, job specific requirements and related regulations + Reviews all claims for completeness, reasonableness of charges, and appropriateness of billing codes, ... accurate account information in each of the appropriate systems (ie entering notes, claims on hold) + Maintains department daily productivity goals in completing a… more
- Walgreens (Antioch, TN)
- …the unique communities we serve as requested by Store Manager, Healthcare Supervisor , or District Manager. Operations + Counsels patients and answers questions ... and federal controlled substance laws when filling prescriptions. The Product Review /Retail Fill Process Pharmacist is responsible for ensuring that elements of… more
- Walgreens (Nashville, TN)
- …as immunizations. Responsible for ensuring the proper compounding, dispensation, review and verification of prescribed medications within regulatory guidelines, ... and assists in community events as requested by Store Manager, Healthcare Supervisor , District Manager or Pharmacy Manager. **Operations** + Under direct supervision… more
- Cardinal Health (Nashville, TN)
- …to patient inquiries in a professional and timely manner. **_Responsibilities:_** + Review aging reports and work patient accounts to ensure timely resolution and ... billing questions and set up payment arrangements if needed. + Analyze claims , process payments and complete adjustments + Analyze explanation of benefits (EOBs)… more
- Walgreens (Nashville, TN)
- …the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Cardinal Health (Nashville, TN)
- …payment + Work average of 50 to 100 denials per day based on supervisor requirements and accounts assigned + Works closely with insurance carriers for reimbursement ... + Consults with appeals department for disputed / denied claims . + Works / Understands electronic claim interchange +...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- Walgreens (Clarksville, TN)
- …as immunizations. Responsible for ensuring the proper compounding, dispensation, review and verification of prescribed medications within regulatory guidelines, ... and federal controlled substance laws when filling prescriptions. The Product Review /Retail Fill Process Pharmacist has the ultimate responsibility for ensuring that… more
- HCA Healthcare (Nashville, TN)
- …is available to assist the attorney in their payer disputes to be able to resolve claims timely. What you will do in this role: + Legal research and analysis of ... regulations, documents and policies + Review and negotiate effective resolution of assigned matters +...Relevant business experience may substitute legal experience requirement with Supervisor approval. + License to practice law in good… more
- Walgreens (Nashville, TN)
- …Quality Improvement Program. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with ... one's own performance, solicits for constructive feedback, and leverages Healthcare Supervisor as mentor and coach. **Communication** + Communicates with pharmacy… more