• Claims Care Associate

    Lincoln Financial Group (Nashville, TN)
    …**Requisition #:** 72954 **The Role at a Glance** We are excited to bring on a Claims Customer Care Associate to join our claimant excellence team supporting ... Group Protection in a remote environment. Background Details The Claimant Excellence Team will...development to perform in this fast-paced environment. As a Claims Customer Care Associate , you… more
    Lincoln Financial Group (11/16/24)
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  • Director, Claims ( Remote )

    Trustmark (Nashville, TN)
    …the best to our colleagues, clients and communities. Responsible for overseeing a claims processing organization. Ensures claims are processed in a timely manner ... in accordance and compliant with government regulations. Develops claims adjudication policies and procedures that maximize the accuracy of claims payments.… more
    Trustmark (11/05/24)
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  • Employee Safety and Risk Claims Consultant

    Sevita (Nashville, TN)
    …more than 50 years, our team members have provided home and community-based health care for adults, children and their families across the United States. As a member ... lives of others? In the Employee Safety and Risk Claims Consultant role, you will contribute to the company's...achieve overall claim cost reduction. This role is 100% remote and can be performed from anywhere in the… more
    Sevita (09/24/24)
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  • Medical Director-- Claims Management

    Humana (Nashville, TN)
    …and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized at the Inpatient ... communication of decisions to internal associates, and possible participation in care management. The clinical scenarios predominantly arise from inpatient or… more
    Humana (10/29/24)
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  • Associate Director, Global Labeling Lead…

    Takeda Pharmaceuticals (Nashville, TN)
    …in order to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director, Global Labeling Lead where you will be responsible for the ... labeling requirements to be provided to patients and Health Care Providers while minimizing the risk of write-offs. +...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
    Takeda Pharmaceuticals (10/16/24)
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  • Medicare Healthcare Internal Consultant…

    Vanderbilt University Medical Center (Nashville, TN)
    …Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care , VUMC is a community of diverse individuals who come to work each ... to advance health and wellness through preeminent programs in patient care , education, and research. **Organization:** Regulatory Oversight **Job Summary:** JOB… more
    Vanderbilt University Medical Center (11/07/24)
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  • Litigation and Risk Associate General…

    Sevita (Nashville, TN)
    …more than 50 years, our team members have provided home and community-based health care for adults, children and their families across the United States. As a member ... and experience a career well lived. **Litigation and Risk Associate General Counsel** Do you have a law degree...help develop systems and procedures to assure optimal quality care for the individuals we serve. This role is… more
    Sevita (10/23/24)
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  • Associate Director, Access and Patient…

    Cardinal Health (Nashville, TN)
    …products are used. **What this position contributes to Cardinal Health:** The Associate Director, Access and Patient Support (APS) is responsible for the tactical ... of collaboration and integration with cross functional teams. The Associate Director oversees revenue and budget accountability, organizational development, and… more
    Cardinal Health (11/14/24)
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  • Associate Director - Business Process

    Trustmark (Nashville, TN)
    …benefits products (ie, sales, implementation and enrollment, underwriting, billing, servicing, claims ) using DMAIC, PDCA, etc. methods. Develop the approach and ... office in Lake Forest, IL for 3 days. Fully remote candidates are also welcome to apply.*_** Brand: Trustmark...FSA and HSA, 401(k) plan, Employee Assistant Program, Back-up Care for Children, Adults and Elders and many health… more
    Trustmark (11/13/24)
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  • Manager Medical Coding

    Humana (Nashville, TN)
    …**Use your skills to make an impact** **Required Qualifications** + A minimum of an Associate 's Degree + 5 or more years of experience in medical auditing & coding ... 6 or more years of work experience related to claims with an understanding claims lifecycles/healthcare revenue...team of offshore associates **Additional Information** **Work Style** : Remote **HireVue Statement** : As part of our hiring… more
    Humana (10/29/24)
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  • Clinical Investigation Lead

    Humana (Nashville, TN)
    …for our members and providers, all while driving health outcomes and cost-effective care for our members. We are seeking a Clinical Investigation Lead to provide ... strategic direction to drive appropriate care , with the aim of reducing waste and overuse...to bring forth a pipeline of potential initiatives. **Location:** remote In this lead role you'll have the opportunity… more
    Humana (11/09/24)
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  • Lead Research Scientist

    Humana (Nashville, TN)
    …first** Humana's Clinical Analytics Team is seeking a Lead Research Scientist ( Remote ). Healthcare is rapidly changing, and our members are living longer, often ... clinical concepts and extract clinical information from medical, pharmacy, and lab claims for analytics and modeling purposes + Translates analytic results into key… more
    Humana (11/09/24)
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  • Medicare Grievances and Appeals Corporate Medical…

    Humana (Nashville, TN)
    …The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems of ... of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products...protect member PHI / HIPAA information This is a remote position **Scheduled Weekly Hours** 40 **Pay Range** The… more
    Humana (10/29/24)
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  • Code Edit Disputes Team Medical Coding Coordinator

    Humana (Nashville, TN)
    …researches/reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or recovery. Analyzes, enters ... knowledge. **Use your skills to make an impact** **WORK STYLE:** 100% remote /work at home. **WORK HOURS:** Typical business hours are Monday-Friday, 8 hours/day,… more
    Humana (11/07/24)
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  • Senior Disability Underwriter

    Humana (Nashville, TN)
    …for complex accounts + Experience analyzing a wide variety of health or claims related data **Additional Information** **Why Humana?** At Humana, we know your ... space lacking ongoing interruptions to protect member PHI / HIPAA information \#LI- Remote **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below… more
    Humana (10/29/24)
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