- Lincoln Financial (Nashville, TN)
- …for this opportunity. **Requisition #:** 74565 **The Role at a Glance** As an Appeals Specialist you will be responsible for being a product subject matter ... for multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. You will… more
- Baptist Memorial (Memphis, TN)
- Overview Specialist -Denial Mitigation II RN Job Code: 21432 FLSA Status Job Family: FINANCE Job Summary The Denial Mitigation-Appeal Specialist II RN serves in a ... and denial resolution in order to defend our revenue. The Denial Mitigation-Appeal Specialist II RN reviews the denial received from the payer, completes a thorough… more
- Baptist Memorial (Memphis, TN)
- Overview Specialist -Denial Mitigation II RN Job Code: 21432 FLSA Status Job Family: FINANCE Job Summary The Denial Mitigation-Appeal Specialist II RN serves in a ... and denial resolution in order to defend our revenue. The Denial Mitigation-Appeal Specialist II RN reviews the denial received from the payer, completes a thorough… more
- HCA Healthcare (Nashville, TN)
- …local, state and federal agencies and accrediting bodies. The Inpatient Coding Denials Specialist must ensure timely, accurate, and thorough appeals for all ... that invests in you as an Impatient Coding Denial Specialist ? At Parallon, you come first. HCA Healthcare has...We are looking for a dedicated Impatient Coding Denial Specialist like you to be a part of our… more
- HCA Healthcare (Nashville, TN)
- …for benefits may vary by location._** We are seeking a Clinical Denials Coding Review Specialist for our team to ensure that we continue to provide all patients with ... apply! **Job Summary and Qualifications** Seeking a Clinical Denials Coding Review Specialist , who is responsible for applying correct coding guidelines and payor… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Billing Specialist II is responsible for processing and auditing insurance claims, rebilling denied claims, and resolving billing discrepancies ... compliance with payer regulations and corporate policies. The Billing Specialist II demonstrates advanced knowledge of billing procedures, coding standards,… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ... role conducts admission and continued stay reviews, supports denials and appeals activities, and collaborates with healthcare providers to facilitate efficient… more
- Army National Guard Units (Nashville, TN)
- …EXCEPTED SERVICE POSITION. This National Guard position is for a TRAFFIC MANAGEMENT SPECIALIST (TITLE 5), Position Description Number NGT5799501 and is part of the ... Chapter 115 (Pyramid on the River Chapter). Responsibilities As a TRAFFIC MANAGEMENT SPECIALIST GS-2130-09 (TITLE 5) you will support the DMC with the planning and… more
- J&J Family of Companies (Nashville, TN)
- …**Job Description:** We are searching for the best talent for Area Business Specialist to be in Nashville TN. **About Immunology** Our expertise in Innovative ... of the way. Learn more at https://www.jnj.com/innovative-medicine As the Area Business Specialist (ABS), you will: + Ensure appropriate identified new and existing… more
- Baptist Memorial (Memphis, TN)
- Overview Job Summary The Accounts Receivable Follow Up Specialist performs all collection and follow up activities with third party payers to resolve all outstanding ... team efforts in the achievement of accounts receivable performance goals. The Specialist performs daily activities related to the successful closure of aged accounts… more
- Bureau of Naval Personnel (Millington, TN)
- Summary You will serve as a SUPERVISORY HUMAN RESOURCES SPECIALIST (EMPLOYEE RELATIONS/LABOR RELATIONS) in the BUREAU OF NAVAL PERSONNEL (BUPERS) DIVISION of BUREAU ... assigned programs. You will manage the proper processing of employee appeals , complaints, and grievances. You will negotiate and draft collective bargaining… more
- CVS Health (Franklin, TN)
- …including insurance plan types, PBM and major medical benefits, prior authorizations and appeals processing. + Ability to work in a fast paced environment, handling ... both inbound and outbound calls. + Must be organized, detail-oriented and able to document cases clearly and accurately in accordance with the program guidelines. + Good communication skills are essential, both internal and external. + Knowledge of Medicare… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Coding Specialist , Centralized Coding Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is East Tennessee's ... personnel to resolve issues related to claims, coding, pre-cert, and denials appeals , and verifies that appropriate chargemaster rates are used. + Reviews medical… more
- Cognizant (Nashville, TN)
- …implementation of process initiatives to reduce denials. The Accounts Receivable Specialist role responsibilities include following up directly with payers to ... action to resolve accounts including drafting and submitting technical appeals . **Key Responsibilities:** + **Problem Solving** : Use exceptional problem-solving… more
- Cardinal Health (Nashville, TN)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will ... the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials, to ensure timely and accurate reimbursement. + Processes… more
- Evolent (Nashville, TN)
- …Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the ... of best practices. + Provides clinical rationale for standard and expedited appeals . + Discusses determinations (peer to peer phone calls) with requesting physicians… more