- 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
- Prime Therapeutics (Nashville, TN)
- …Management experience to include 1 year of work experience in an operations, audit or quality assurance environment + Must be eligible to work in the United ... fuels our passion and drives every decision we make. **Job Posting Title** Pharmacy Claims Auditor - Remote **Job Description** The Pharmacy Claims Auditor is… 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
- Prime Therapeutics (Nashville, TN)
- …work experience in claims processing in an operations, audit or quality assurance environment##1 year of work experience in insurance, billing, collections ... agency. This position ensures payment recoveries are accurately processed in Prime's systems for recoupment of audits and investigations performed by the Pharmacy… more
- NASCO (Nashville, TN)
- …+ Performs Estimates and Designs on small to medium CSRs (<1000 hours) + Participates in quality assurance and code reviews. + Serves as a team lead on small to ... you will tackle moderate to complex technical challenges, enhancing data management and claims processing systems for NASCO and its partners. Collaborating with… 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
- 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
- Cherry Bekaert (Nashville, TN)
- …also assist in an administrative project management capacity, spearheading projects around accounting systems , claims systems , premium systems and ... and geographic location. In addition, we offer a comprehensive, high- quality benefits program (https://careers.cbh.com/benefits/) which includes annual bonus, medical,… more