• Team Lead - Claims

    CVS Health (Franklin, TN)
    …day. **Position Summary** The Team Lead for the Medicare Supplement Claims Processing team is responsible for overseeing day-to-day operations to ... insurance claims processing , preferably with Medicare Supplement claims . * Proven ability to lead or mentor others in a team environment. * Strong… more
    CVS Health (05/31/25)
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  • Lead Representative, Accounts Receivable

    Cardinal Health (Nashville, TN)
    …organizational skills and prioritizes getting the right things done. **The Accounts Receivable Team Lead performs day-to-day AR functions with the goal of ... appropriate. + Acts as a subject matter expert in claims processing . + Processes claims :...claims ; properly resolves by follow-up & disposition. + Lead and manage escalation projects, addressing complex issues and… more
    Cardinal Health (05/21/25)
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  • Lead Director, Health Services

    CVS Health (Nashville, TN)
    …Skills** + Strong understanding of the healthcare industry, including medical management, claims processing , and provider networks. + Extensive knowledge and ... and guidelines to ensure proper coding and payment. The lead director manages a team of claim...data. + Strong understanding of regulatory requirements related to claims processing . **Preferred Skills** + Proficient in… more
    CVS Health (06/07/25)
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  • Member Team Lead

    Walmart (Jackson, TN)
    …types programs and benefits to current and prospective members processing memberships upgrades and credit accounts encouraging membership renewals participating ... are filled Oversees assigned area of responsibility by handling claims and returns zoning the area arranging and organizing...the best talent Respect the Individual: Works as a team builds strong and trusting relationships communicates with impact… more
    Walmart (05/29/25)
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  • ADA Accommodation Coordinator

    Sedgwick (Memphis, TN)
    …Makes claim determinations to approve non-complex ADA claims or makes a recommendation to team lead to deny claims based on the ADA, state, and/or client ... clinicians, ADA job accommodation specialists). + Refers cases as appropriate to team lead . + Maintains professional client relationships. **ADDITIONAL FUNCTIONS… more
    Sedgwick (05/29/25)
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  • Remote ADA Accommodation Coordinator- Bilingual…

    Sedgwick (Nashville, TN)
    …Makes claim determinations to approve non-complex ADA claims or makes a recommendation to team lead to deny claims based on the ADA, state, and/or client ... clinicians, ADA job accommodation specialists). + Refers cases as appropriate to team lead . + Maintains professional client relationships. **ADDITIONAL FUNCTIONS… more
    Sedgwick (05/15/25)
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  • Representative II, Accounts Receivable

    Cardinal Health (Nashville, TN)
    …+ Mails all paper claims . + Acts as a subject matter expert in claims processing . + Manages billing queue as assigned in the appropriate system. + Manages ... done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will...+ Mentors new hires; assists + Assists management and team lead with motivating and coaching employees… more
    Cardinal Health (05/22/25)
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  • External Audit Facilitator

    Elevance Health (Nashville, TN)
    …Requirements:** Requires HS diploma or equivalent and minimum 2 years internal claims processing (adjustments) experience; or any combination of education and ... would provide an equivalent background. **Preferred Skills, Capabilities and Experiences:** + Claims processing experience + Knowledge of multiple lines of… more
    Elevance Health (05/23/25)
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  • National Health & Benefits Consulting Senior…

    The Cigna Group (Franklin, TN)
    …to the client. + Determine opportunities and identify solutions to increase analytical processing efficiency within the team . + Maintain knowledge of industry, ... this role you will operate as an account management team component of a larger group including Account Executives,...Conduct analyses across various data domains such as medical claims , pharmacy claims , eligibility, etc. + Create… more
    The Cigna Group (06/07/25)
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  • Associate Director, Brand & Sales Analytics

    Otsuka America Pharmaceutical Inc. (Nashville, TN)
    …Director, Brand and Sales Analytics will be part of a high performing team that provides actionable, innovative solutions to address key business questions & ... driven insights on a continuous basis that are actionable + Lead reporting and visualization strategy for various dashboards **Qualifications/ Required** Knowledge/… more
    Otsuka America Pharmaceutical Inc. (05/16/25)
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  • Director, Quantitative Pharmacology, Clinical…

    Otsuka America Pharmaceutical Inc. (Nashville, TN)
    …simulation activities. You will interact with early development and business development team members and external collaborators to assess/ lead development and ... **(PK)** , **Pharmacokinetics-Pharmacodynamics (PK/PD)** and regulatory submissions. You will lead study design, execution and reporting of **clinical pharmacology**… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Call Center Team Leader

    Mass Markets (TN)
    …a call center or customer service environment. + Proven experience in a supervisory or team lead role. + Strong understanding of key performance metrics such as ... industry. We are looking for a motivated and results-driven Team Leader to oversee a team of...736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP),… more
    Mass Markets (03/13/25)
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  • Director, Specialty Pharmacy Operations

    Otsuka America Pharmaceutical Inc. (Nashville, TN)
    …and provide insights to senior leadership on progress toward operational and business goals. ** Team Development & Management:** + Lead , mentor, and develop a ... are seeking a highly skilled and motivated Director of Specialty Pharmacy Operations to lead and oversee the operations for the launch of a new specialty pharmacy… more
    Otsuka America Pharmaceutical Inc. (05/23/25)
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  • Senior Manager, Specialty Pharmacy Operations

    Otsuka America Pharmaceutical Inc. (Nashville, TN)
    …requirements. + Investigate and resolve any challenges related to prescription processing , distribution, patient access, or reimbursement. + Create and manage ... product and channel specific contract strategies **Collaboration with Internal Stakeholders:** + Lead and manage all touchpoints with internal and external parties +… more
    Otsuka America Pharmaceutical Inc. (05/23/25)
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  • Senior Manager, Global Regulatory Affairs

    Otsuka America Pharmaceutical Inc. (Nashville, TN)
    …activities for all assigned projects in alignment with the Global Regulatory Lead . Translates complex pertinent global requirements and provides an assessment of the ... associated regulatory challenges to the GRL, global regulatory team , assigned project teams, and internal/external functional business units as needed. Works… more
    Otsuka America Pharmaceutical Inc. (04/23/25)
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  • Senior Director, Federal Government Affairs

    Otsuka America Pharmaceutical Inc. (Nashville, TN)
    We are seeking a Senior Director, Federal Government Affairs to lead our US federal government engagement in Washington, DC. This position reports to the Vice ... As the strategic leader, and a member of the Government Affairs Leadership Team , the Senior Director of the Federal Government Affairs will play an integral… more
    Otsuka America Pharmaceutical Inc. (04/19/25)
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  • Associate Director, Omnichannel Data Scientist

    Otsuka America Pharmaceutical Inc. (Nashville, TN)
    …those goals. **Job Expectations/Responsibilities:** + Explore and analyze common pharmaceuticals data (eg, claims ) as well as novel data sets based on lab and EHR ... + Collaborate, coach, and learn with a growing Omnichannel Analytics team , identifying and developing long-term processes, frameworks, tools, methods, and standards.… more
    Otsuka America Pharmaceutical Inc. (05/16/25)
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  • Director, Patient Support

    Otsuka America Pharmaceutical Inc. (Nashville, TN)
    **Position Overview** We are seeking an experienced healthcare professional to lead our Nephrology Patient Support program. This role will oversee nurse case ... performance indicators and create analytics to demonstrate program effectiveness + Lead strategic planning and operational execution for the nephrology patient… more
    Otsuka America Pharmaceutical Inc. (05/23/25)
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  • Senior Manager, Field Technology & Reporting

    Otsuka America Pharmaceutical Inc. (Nashville, TN)
    **Position Summary** The Senior Manager of Field Technology will lead the design, optimization, and delivery of field sales reporting platforms and tools. This role ... individual partners closely with the Field Strategy & Operations team , Sales, IT, and Commercial Operations to ensure systems...technology tools and platforms. + Serve as the business lead for execution of field reporting and enablement systems… more
    Otsuka America Pharmaceutical Inc. (05/16/25)
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  • Director, Field Reimbursement Management - Remote

    Otsuka America Pharmaceutical Inc. (Nashville, TN)
    …to serve as the Director of Field Reimbursement Management. This role will lead a team of HCP-facing Field Reimbursement Managers, ensuring optimal patient ... providing education on various payer processes. Key Responsibilities + Lead , mentor, and develop a high-performing team ...offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed,… more
    Otsuka America Pharmaceutical Inc. (05/23/25)
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