- 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
- Southern Company (Chattanooga, TN)
- … I, Safety & Health; 2) Specialist II, Safety & Health; and 3) Specialist Sr . Safety & Health will be based on years of experience and/or education; ... employees in the department and provide guidance for the standardization initiatives. ( Specialist Sr .) **Business Acumen:** * Evaluate existing safety compliance… more
- Sedgwick (Memphis, TN)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer IT Systems Analyst Specialist Sr - ServiceNow **PRIMARY PURPOSE** : To lead the business ... and retiring configuration items (CIs), establishing and enforcing policies, auditing data , and integrating with other IT systems **ADDITIONAL FUNCTIONS and… more
- Sedgwick (Nashville, TN)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Estimate Review Specialist Sr . (Repair Solutions) **PRIMARY PURPOSE** **:** To review all ... reviews, and sends fair and accurate estimates through various platforms. + Records data around initial estimates reviewed, number of reviews, and rejections on all… 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
- Catholic Health Initiatives (Chattanooga, TN)
- **Responsibilities** **Job Summary / Purpose** The Sr Coding Compliance Auditor is responsible for reviewing chart notes for proper coding with an emphasis on ... medical needs are met at the highest level. The Sr Coding Compliance Auditor's primary focus will be to...other portion of time focused on provider communication, and claims denial resolutions. Communicates denial trends to leadership and… more
- Wellpath (Hendersonville, TN)
- …education, and point of care support. **How you make a difference** The Senior Medicaid Support Specialist provides guidance and technical support to field ... accordance with applicable state and local laws. Quick Apply (https://careers-wellpath.icims.com/jobs/176814/medicaid-support- senior - specialist /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336175207) **Need help finding the right job?**… 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
- 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
- Banner Health (TN)
- …areas such as unbilled accounts receivable, compliance with regulatory requirements and data integrity. The position works collaboratively with Sr . Coding ... as unbilled accounts receivable, quality and timeliness of clinical coding assignments, data integrity and reimbursement with third party payers. Provides for the… more
- Covenant Health Inc. (Sevierville, TN)
- Overview Consumer Relation Specialist , Sevier Clinic Full Time, 80 hours per pay period, Day shift Peninsula Overview: Peninsula, a division of Parkwest Medical ... for seniors with co-existing psychiatric and medical conditions at the Senior Behavioral Center located at Parkwest Medical Center (http://www.treatedwell.com/) .… 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