- Sedgwick (Nashville, TN)
- …place to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Complex Claims Advisor | Remote **This ... manages a complex claim inventory by assessing complex claims issues, utilizing jurisdictional expertise to...preferred. **Skills & Knowledge** + Subject matter expertise in worker 's compensation claims and/or liability… more
- Sedgwick (Nashville, TN)
- … Examiner **PRIMARY PURPOSE** **:** To analyze complex or technically difficult workers compensation claims to determine benefits due; to work with ... specific requirements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult claims by investigating and… more
- Sedgwick (Nashville, TN)
- …great place to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Claims Examiner | CT, MA, NH, RI, VT ... brands? + Apply your knowledge and experience to adjudicate complex customer claims in the context of...experience. **PRIMARY PURPOSE OF THE ROLE:** To analyze high-level Workers Compensation claims on behalf… more
- Travelers Insurance Company (Franklin, TN)
- …Openings** 1 **What Is the Opportunity?** Potential for a $3,000 sign-on bonus! Manage Workers ' Compensation claims with lost time to conclusion and ... paid out. With close to moderate supervision, may handle claims of greater complexity where Injured worker ...**What Will Our Ideal Candidate Have?** + 2 years Workers Compensation claim handling experience preferred. +… more
- UMB Bank (Nashville, TN)
- …change to ensure the best customer experience. + Review and decide high-value and complex card fraud claims . + Prepare regular reports on card fraud ... **Duties & Responsibilities** The Manager, Card Fraud Claims , will oversee and manage the UMB card...College Degree + TSYS TS2 and/or TSYS TMS experience ** Compensation Range:** Minimum: $69,230.00 - Maximum: $179,300.00 _The posted… more
- Elevance Health (Nashville, TN)
- …member on multiple platforms. Fully proficient in all key areas; performs multi complex functions and interprets complex rules, laws and contracts. Accountable ... entitled. + Determines primacy on each case using a complex set of Primacy Rules as mandated by State...enrolling in Medicare. + Reviews claim history to identify claims requiring reconciliation, whether processed or pended, as well… more
- Elevance Health (Nashville, TN)
- …and procedures. + Investigates potential fraud and over-utilization by performing the most complex medical reviews via prepayment claims review and post payment ... and/or fraudulent activities by health care providers through prepayment claims review, post payment auditing, and provider record review....in good faith believes is the range of possible compensation for this role at the time of this… more
- Chewy (Mount Juliet, TN)
- …and assists in the investigation of employee complaints or concerns. + Coordinates worker 's compensation claims and unemployment claims . + ... (FMLA), Employee Retirement Income Security Act (ERISA), the Department of Labor, worker compensation , the Occupational Safety and Health Administration (OSHA).… more
- Sedgwick (Nashville, TN)
- …+ Produces and manages reporting metrics and analytics for all leave cases and workers ' compensation claims . Presents reports as requested. + Partners ... + Assists in the creation and facilitation of leave administration and workers ' compensation training programs. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** +… more
- Elevance Health (Nashville, TN)
- …other coverage for all of the company's groups and members. Performs multi complex functions and interprets complex rules, laws and contracts. Accountable for ... identify the correct formulas in order to adjudicates impacted claims , using multiple COB Formulas for the various product...in good faith believes is the range of possible compensation for this role at the time of this… more
- Travelers Insurance Company (Franklin, TN)
- …to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation , General Liability and other areas of the business as ... Imagine loving what you do and where you do it. **Job Category** Claim ** Compensation Overview** The annual base salary range provided for this position is a… more
- Sedgwick (Nashville, TN)
- …and support systems. + Effectively communicates and builds relationships with the claims ' examiner, client, injured worker , attorney and supervisor. + Identifies ... Manager **PRIMARY PURPOSE OF THE ROLE:** While partnering with the injured worker , employer, and medical providers, create a case management strategy to facilitate… more
- Shoals Technology Group (Nashville, TN)
- …complex employment matters, including offers and separations; employee compensation ; discipline and discharge issues; diversity and inclusion; employee ... of issues including employee relations, wage and hour issues, worker classifications, restructurings, workplace investigations, employee litigation, performance management… more
- Elevance Health (Nashville, TN)
- …are all pharmacy processes and processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries. **How you ... as assigned and acts as auditor in charge on small and less complex audits. + Participates in pre and post implementation audits ofpharmacy operational processes,… more
- Elevance Health (Nashville, TN)
- …the enterprise. Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries. **How ... level function as subject matter experts, conducting routine to complex audits, generally related to multiple functions on multiple...in good faith believes is the range of possible compensation for this role at the time of this… more
- Elevance Health (Nashville, TN)
- …acceptability of insurance risks and appropriate premium rates for large, complex renewal and prospect employer groups in accordance with Corporate Underwriting ... are not limited to: + Calculates renewal rates for complex group cases based on thorough analysis of the...increments or decrement. + Communicates with sales, administration and claims to assess the rating and administrative impact or… more
- Elevance Health (Nashville, TN)
- …on the team. **How you will make an impact:** + Undertakes complex assignments requiring additional specialized technical knowledge. + Develops very complex ... costs for own and other projects. + Develops and supports very complex data warehouse-related applications for business areas requiring design and implementation of… more
- Elevance Health (Nashville, TN)
- …is responsible for conducting research and collecting and entering data for complex and moderately varied issues and situations related to the Prior Authorization ... and PC skills. + Processing in FISS and/or MCS claims processing system. + Letter processing/mailing. + Phone calls...in good faith believes is the range of possible compensation for this role at the time of this… more
- Elevance Health (Nashville, TN)
- …operational excellence that meets/exceeds client service and satisfaction goals for a complex book of business supporting pharmacy. **How you will make an impact:** ... strongly preferred. + Experience or knowledge of Salesforce and/or claims operating systems highly preferred. + Proficient of Microsoft...in good faith believes is the range of possible compensation for this role at the time of this… more
- Elevance Health (Nashville, TN)
- …care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, ... as applicable. + Assists in problem solving with providers, claims , or service issues and all member needs or...in good faith believes is the range of possible compensation for this role at the time of this… more