- CVS Health (Franklin, TN)
- …with a focus on compliance and FWA detection * Proficiency in analyzing claims data and reporting tools (Excel, SQL, Tableau, etc.) **Preferred Qualifications** ... day. **Position Summary** Performs detailed review and analysis of Medicare Supplement claims . Verifies claim validity, and ensures accurate and timely… more
- HCA Healthcare (Nashville, TN)
- …goals. Unlock your potential! **Job Summary and Qualifications** Seeking an Electronic Data Interchange (EDI) Enrollment Specialist , who is responsible for ... hours volunteering in our communities. As a EDI Enrollment Specialist with Parallon you can be a part of...role: + Prepare and submit applications to configure Electronic Data Interchange (EDI) claims and Electronic Remittance… more
- Zurich NA (Nashville, TN)
- …able to document claim files by accurately capturing and updating claims data /information in compliance with best practices. Basic Qualifications: + ... Complex Liability Claims Specialist 123220 Zurich is currently...regular communication with customers, brokers, our Business Units and senior Claims management. The ideal candidate will… more
- Vanderbilt University Medical Center (Nashville, TN)
- …and liver-kidney. . The VUMC Pediatric Transplant Department is in need of a ** Senior Financial Clearance Specialist ** to join the team! **Shift:** Monday - ... with minimal guidance. This position will provide guidance as a financial clearance specialist at any time during the patients transplant care. Candidates with a… more
- Fujifilm (Nashville, TN)
- **Position Overview** The accomplished Senior Corporate Compliance Specialist will support FUJIFILM's Corporate Compliance Program's operations to ensure high ... status of action plans, and prepare related reports. + Manage transparency data collection, validation, and reporting process to ensure compliance with the… more
- Vanderbilt University Medical Center (Nashville, TN)
- …account inquiries and payer denials. . KEY RESPONSIBILITIES * Processes claims , payments, adjustments, refunds, denials, and unpaid patient and insurance balances. ... third party payors, and administrative personnel. * Analyzes incoming financial data to identify, reconcile, and resolve patterns resulting in erroneous or… more
- Highmark Health (Nashville, TN)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of ... policies, practices, and standards. Analyzes associated policies, guidelines, market data to continuously improve risk management and gain appropriate enrollment… more
- Highmark Health (Nashville, TN)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent develops and uses ... policies, practices, and standards. Analyzes associated policies, guidelines, market data to continuously improve risk management and gain appropriate enrollment… more
- Medtronic (Nashville, TN)
- …articulate to customers. + Execute engaging field sales and clinical specialist field education programs that are targeted, purposeful, and support electrophysiology ... Clinical Expert + Translates complex technical messaging, dispels competitive claims , resolves complex technical issues, and maintains customer relationships through… more