- Humana (Nashville, TN)
- …career to the next level by driving real impact and shaping the future of claims management? As a Senior Pharmacy Claims Professional, you will play a pivotal ... on building solutions that make a difference! The Senior Pharmacy Claims Professional analyzes and answers inquiries regarding pharmacies' outstanding balances… more
- Sedgwick (Nashville, TN)
- …but not limited to Bachelor of Science in Nursing, Legal Nurse Consultant, Associate in Claims (AIC), Chartered Property and Casualty Underwriter (CPCU), ... + Identifies and investigates for possible fraud, subrogation, contribution, recovery , and case management opportunities to reduce total claim...Associate in Risk Management (ARM), Associate in Insurance Claims (AIC), Certified Professional… more
- Elevance Health (Nashville, TN)
- …Coordinates with concerned unit/brand as appropriate regarding approved interventions such as recovery of overpayment, pre-payment audit of claims or putting ... in-depth investigations on identified providers and members as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to… more