- Public Consulting Group (Nashville, TN)
- …Education + Recovery Services **Duties and Responsibilities** + Analyzes the development of claims assigned at each level of the adjudication process. + Outlines the ... sent with applications. + Monitors and gives direction to Claims Developer regarding specific tasks on claims ....to Claims Developer regarding specific tasks on claims . + Provides monthly reporting statistics. + Ensures adherence… more
- Prime Therapeutics (Nashville, TN)
- …our passion and drives every decision we make. **Job Posting Title** Pricing Analyst - Remote **Job Description** The Pricing Analyst maintains, provides ... with high-complexity pricing analyses. **Responsibilities** + Analyze and produce pharmacy claims data reporting of varying complexity to assess competitiveness &… more
- Prime Therapeutics (Nashville, TN)
- …passion and drives every decision we make. **Job Posting Title** Sr. Pricing Analyst - Pharmacy Network - Remote **Job Description** The Senior Pricing Analyst ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
- CVS Health (Nashville, TN)
- …to GPS to rework claims after validating as overpaid **Required Qualifications** * 1 years experience working with GPS and ECHS * Knowledge of ACAS claims ... This position will be responsible for utilizing previous ACAS claims experience along with provided guidance to review and...experience along with provided guidance to review and validate claims for overpayment. The ideal candidate will be able… more
- HCA Healthcare (Brentwood, TN)
- …want to join an organization that invests in you as a Billing Integrity Analyst Credentialed? At Parallon, you come first. HCA Healthcare has committed up to $300 ... difference. We are looking for a dedicated Billing Integrity Analyst Credentialed like you to be a part of...based on the chargemaster expertise and that are delaying claims from processing in the Patient Accounting and/or Relay… more
- PRGX (Nashville, TN)
- …clients in more than 30 countries with the business intelligence to recover $ 1 .2 billion in annual cash flow, unlocking value and improving the overall health ... business operations. + Finds, supports, and documents audit and claims operations. + Produces claims using appropriate audit concepts for writing claims ,… more
- Prime Therapeutics (Nashville, TN)
- …years of work experience. + Prior experience as a Business Intelligence Developer/ Analyst or Data Analyst supporting business intelligence, reporting, analytics ... that may be in use in a Pharmacy Benefit Management setting ( Claims Processing, Prior Authorization, Telephony, Membership, etc.). + Consideration will be given… more
- Baylor Scott & White Health (Nashville, TN)
- …while aligning with internal SMEs and current capacities. We have over 1 million lives across multiple blocks of business and industry-leading analytics to ... support our organization. We seek a stakeholder-facing statistical analyst that will be responsible for the extraction, analysis and interpretation of data to… more
- Prime Therapeutics (Nashville, TN)
- …Title** Treasury Reporting Principal - Remote **Job Description** The Treasury Analyst Principal is responsible for managing, analyzing, and delivering Treasury ... Team and guidance to the Accounting, Finance, Information Technology and Claims operation functions. **Responsibilities** : + Develop, manage, and advance monthly… more