- LifePoint Health (Brentwood, TN)
- …hospital leadership. This position also provides oversight to the DRG Downgrade Appeals Specialist team. *Responsibilities:* . Oversee the operations and human ... and implement process changes to maintain and improve KPIs. . Develop and execute appeals management strategies for the DRG downgrade team. . Develop and monitor key… more
- Randstad US (Franklin, TN)
- revenue cycle specialist . + franklin , tennessee + posted 7 days ago **job details** summary + $23.99 - $24 per hour + temp to perm + high school + category office ... 100% in office* We are seeking a Revenue Cycle Specialist to join our team in Franklin, TN. This...aspects of the revenue cycle process. This includes handling appeals and denials management to ensure that claims are… more
- Robert Half Accountemps (Chattanooga, TN)
- Description We are searching for an Insurance Follow-Up Specialist in Chattanooga, Tennessee. This role operates within the healthcare industry and is a contract ... employment opportunity. As an Insurance Follow-Up Specialist , you will manage tasks related to medical collections and insurance follow-up, with a focus on Medicare… more
- Healthfirst (TN)
- …as: certain types of claim denials, member complaints, and member and provider appeals . The end-to-end process requires the Specialist to independently: + ... Work within a framework that measures productivity and quality for each Specialist against expectations + Additional duties as assigned **Minimum Qualifications** +… more
- Covenant Health Inc. (Morristown, TN)
- Overview Human Resources Operations Specialist Morristown-Hamblen Health System Full time, 80 hours per pay period, Day Shift Morristown Hamblen Overview: ... Tennessee Department of Employment Security Claims and represents Covenant Health on appeals . + Conducts follow up regarding findings from Compensation, HRIS, or… more
- Cardinal Health (Nashville, TN)
- …+ Must follow through on all benefit investigation rejections, including Prior Authorizations, Appeals , etc. All avenues to obtain coverage for the product must be ... documenting patient health insurance benefit investigations, prior authorizations, and appeals , preferred + Cell/Gene therapy and/or Oncology experience, preferred +… more
- Sutherland Global Services (Nashville, TN)
- …phone, email, or online + Providing ongoing appropriate collection activity on appeals + Requesting additional information from Patients, Medical Records, and others ... as needed + Communicating with insurance plans and researching health plans for benefits and types of coverage + Reviewing contracts and identifying billing or coding issues and requesting re-bills, secondary billing, or corrected bills as needed. + Handling… more
- HCA Healthcare (Nashville, TN)
- …Unlock your potential! **Job Summary and Qualifications** The Clinical Review Specialist is responsible for performing retrospective medical reviews based on patient ... plan, and/or hospital setting + A minimum of one-year experience with denials and appeals in a clinical setting preferred + A minimum of one-year experience in a… more