- Lincoln Financial Group (Nashville, TN)
- …more about a Day in the Life (https://www.youtube.com/watch?v=vbSYiXOPSII) of a Claims Specialist at Lincoln Financial Group ! **What you'll be doing** + ... We are excited to bring on a highly motivated ** Group Claims Specialist** to support our ever-growing...guidance and solutions across four core businesses - annuities, life insurance, group protection and retirement plan… more
- Lincoln Financial Group (Nashville, TN)
- …customers trust our guidance and solutions across four core businesses - annuities, life insurance, group protection and retirement plan services. As of December ... reviewing, analyzing, and interpreting medical information available for disability claims . In this role you will act as a...role you will act as a clinical resource for Group Protection benefit specialists and claim professionals. You will… more
- The Cigna Group (Nashville, TN)
- …year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group . **About Evernorth Health Services** Evernorth Health ... claim trend targets are met. + Utilize internal data such as claims , completed negotiations and network composition along complete and external benchmarking to… more
- HUB International (Brentwood, TN)
- … claims and managed care functions in assigned jurisdictions + Assist claims management in monitoring and researching jurisdictional case law and statutory ... **About Specialty Program Group :** Our goal is to partner with industry-leading...subsidiaries reside: + Avant Underwriters (AU + Avant Specialty Claims (ASC) + Avant Brokerage (AB) + Avant Supermarket… more
- Elevance Health (Nashville, TN)
- …members in enrolling in Medicare when they are entitled. + Determines primacy on each case using a complex set of Primacy Rules as mandated by State and Federal ... such as CMS Primacy and NAIC rules and comparing them against the member/ group Benefits. + Updates all of the company's membership system components with… more
- Humana (Nashville, TN)
- …first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post acute… more
- Humana (Nashville, TN)
- …first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post-acute services… more
- CGI Technologies and Solutions, Inc. (Nashville, TN)
- …determining their annual rent adjustments, reconciling monthly payment requests, processing claims for unpaid rent and damages and extended vacancies. The Specialist ... to join an energetic team with a collaborative management group and work with affordable housing owners and management...annual contract rent adjustments * Evaluate and approve owner's claims for reimbursement due to unpaid rent, tenant damages… more
- J&J Family of Companies (Nashville, TN)
- …learning algorithms to analyze large-scale healthcare datasets, including HER/EMR and claims data. * **Predictive Modeling & Forecasting:** Design, implement, and ... Qlik.) a plus + Real world data experience preferred (EMR/EHR, medical claims , pharmaceutical, etc.); experience with international healthcare data a plus + Deep… more
- J&J Family of Companies (Nashville, TN)
- …may be considered for qualified candidates. Remote work options may be considered, on a case -by- case basis and if approved by the Company. At Johnson & Johnson, ... the economic value of products and therapies with clinical and quality of life outcomes data from clinical trials and/or epidemiology studies. * Support the… more
- Norstella (Nashville, TN)
- …patient access. Each organization (Evaluate, MMIT, Panalgo, The Dedham Group ) delivers must-have answers for critical strategic and commercial decision-making. ... nearly three decades. MMIT believes that patients who need life -saving treatments should not face delays because accessing drugs...for business alignment by client type and RWD use case to advise on pre-sales activities such as solution… more