- The Cigna Group (Nashville, TN)
- ** Quality Assurance Claims Systems Auditor, Senior Analyst** Are you passionate about driving growth and improving lives? EviCore, a division of The ... Cigna Group is seeking a Quality Assurance Claims Systems Auditor, Senior Analyst. In this critical role, you'll audit all contract details loaded into… more
- Otsuka America Pharmaceutical Inc. (Nashville, TN)
- …detecting, and correcting non-compliance and mitigating risks, The performance of the Quality Systems and Risks will be reported periodically to Senior ... Summary** We are seeking an experienced and dynamic Executive Director of R&D Global Quality to join our team. This pivotal role will be responsible for leading a… more
- Prime Therapeutics (Nashville, TN)
- …requestors to resolve questions regarding requested software changes, and participate with Quality Assurance resources to review related test cases and/or ... drives every decision we make. **Job Posting Title** IT Systems Analyst **Job Description** The IT Systems ...in PBM / health care industry and/or experience in claims processing data + Experience in SQL, Redshift, and… more
- Elevance Health (Nashville, TN)
- …at least one of the following: AA/AS or minimum of 15 years of experience in claims auditing, quality assurance , or recovery auditing. + Requires at least ... / Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad, deep...preferred. + Broad, deep and niche knowledge of medical claims billing/payment systems provider billing guidelines, payer… more
- AO Smith (Lebanon, TN)
- …order to support and maintain assigned region. + Communicate with manufacturing, quality assurance , sales and engineering to resolve customer complaint issues. ... company policies, processes and procedures. + Negotiate validated labor claims with Reps & non-CSP's + Travel 80% in...+ Record, analyze, and inform concerned associates of production quality assurance , and sales departments of status… more
- Elevance Health (Nashville, TN)
- …at least one of the following: AA/AS or minimum of 5 years of experience in claims auditing, quality assurance , or recovery auditing. + Requires at least one ... assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies,… more
- Elevance Health (Nashville, TN)
- …in applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance , or clinical documentation improvement, and a ... preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems , provider billing guidelines, payer… more
- Otsuka America Pharmaceutical Inc. (Nashville, TN)
- …in regulatory affairs or related areas (eg, clinical development, project management, quality assurance , etc.) in pharmaceutical or healthcare related industry. ... and guidelines. - Confirms submission documents are accurate, compliant, and high- quality to allow for smooth and expeditious approvals from regulatory authorities.… more
- Vanderbilt University Medical Center (Nashville, TN)
- …system according to written and verbal instructions efficiently and accurately. + Quality Assurance (Novice): Understands the goal of increasing organizational ... and accurate assignment of codes to survey data. + Maintains departmental quality , data reliability and ensures productivity standards. + Assists with aggregation… more
- GAF (Nashville, TN)
- …The Process Manager works closely with Operations leadership, Plant personnel, R&D, Quality Assurance , and Supply Chain. **Essential Duties** + Work within ... and equipment, and recommended maintenance standards for the plant systems . + Collaborate with Corporate teams and Plants to...Provide expertise and utilize the CoP to address plant quality issues or large claims + Drive… more
- Highmark Health (Nashville, TN)
- …various aspects of project implementations, system upgrades, break/fix issues, training and quality assurance processes. Assist in system functional and user ... build, implementation, training, evaluation, testing and maintenance of all Revenue Cycle systems (Epic, Meditech, nThrive, etc.) Functions on an advanced level in… more