- Evolent (Nashville, TN)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Specialist , Credentialing Operations will be a dynamic role that will encompass ... auditing. This position reports to the Associate Director, Credentialing Operations . **Collaboration Opportunities:** The Specialist , Credentialing Operations… more
- CVS Health (Nashville, TN)
- …training needs within the claims processing department. **Position Summary** **This is a Claim Benefit Specialist position and will be trained for 20 ... skills. **What you will do** + Handles and processes Benefits claims submitted by healthcare providers, ensuring...and guidelines. + Determines the eligibility and coverage of benefits for each claim based on the… more
- Cardinal Health (Nashville, TN)
- **_What Finance Operations contributes to Cardinal Health_** This role supports the Chargebacks Team within the Customer Operations department. Key ... responsibilities in this role include processing chargeback claims from pharmaceutical wholesalers to manufacturers, verifying membership, and performing contract… more
- HCA Healthcare (Nashville, TN)
- … claims compliance reporting/audits preferred + Three years (3) experience in a Claims operations position required + Five years (5) previous experience in a ... incredible team members over the course of three years. ** Benefits ** Work from Home, offers a total rewards package...part of our team. **Job Summary and Qualifications** The ** Claims Compliance Specialist f** or SCCIPA serves… more
- Vanderbilt University Medical Center (Nashville, TN)
- …Payor/Provider Enrollment **Job Summary:** JOB SUMMARY A payor enrollment specialist is responsible for tracking the process of enrolling healthcare ... of data/documents for providers and locations for them to successfully submit claims for payment. + Assures enrollment with outside affiliates by coordinating data… more
- Sedgwick (Nashville, TN)
- …Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer IT Systems Analyst Specialist **PRIMARY PURPOSE** : To review, analyze and document software ... as appropriate. + Works with project managers, project requestors, operations , business representatives, IT representatives and clients to ensure complete… more
- Elevance Health (Nashville, TN)
- **Pharmacy Quality Assurance Specialist ** **Location:** The employee must live within 50 miles of an open access Elevance Health PulsePoint (within 50 miles of the ... office 1-2 days per week. The **Pharmacy Quality Assurance Specialist ** will be responsible for evaluating the quality of...Included are processes related to enrollment and billing and claims processing, as well as customer service written and… more
- Vanderbilt University Medical Center (Nashville, TN)
- …with minimal guidance. This position will provide guidance as a financial clearance specialist at any time during the patients transplant care. Candidates with a ... Department is in need of a **Senior Financial Clearance Specialist ** to join the team! **Shift:** Monday - Friday,...of the appropriate rules and regulations for insurance policies, claims , payment and coverage. Ability to interpret and explain… more
- Prime Therapeutics (Nashville, TN)
- …our passion and drives every decision we make. **Job Posting Title** Enrollment Specialist - ADAP - Remote in Connecticut **Job Description Summary** This position ... of enrollment, assessment and dis-enrollment documentation for strategic business unit (SBU) operations . **Job Description** + This is a remote work from home… more
- Vanderbilt University Medical Center (Nashville, TN)
- …. The VUMC Oral Surgery Department is in need of a **Financial Clearance Specialist PRN** to join the team! **Shift:** Monday - Friday, 1st shift as needed ... Demonstrates knowledge of the appropriate rules and regulations for insurance policies, claims , payment and coverage. Ability to interpret and explain rules and… more
- Vanderbilt University Medical Center (Nashville, TN)
- …account inquiries and payer denials. . KEY RESPONSIBILITIES * Processes claims , payments, adjustments, refunds, denials, and unpaid patient and insurance balances. ... employees stay at Vanderbilt Health for professional growth, appreciation of benefits , and a sense of community and purpose. **Core Accountabilities:** *… more