• Medicare Specialist

    HCA Healthcare (Hendersonville, TN)
    …**Introduction** Do you want to join an organization that invests in you as a Medicare Specialist ? At Parallon, you come first. HCA Healthcare has committed up ... have the opportunity to make a difference. We are looking for a dedicated Medicare Specialist like you to be a part of our team. **Job Summary and… more
    HCA Healthcare (01/10/25)
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  • Internal Sales Specialist

    Baylor Scott & White Health (Nashville, TN)
    **JOB SUMMARY** The Internal Sales Specialist obtains new enrollments and facilitates community outreach in the assigned service area. **ESSENTIAL FUNCTIONS OF THE ... ROLE** Coordinates and conducts sales activities for Individual and Medicare Advantage plans to enroll prospective members into the health plan to increase… more
    Baylor Scott & White Health (01/09/25)
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  • Hierarchical Condition Category (HCC) Coding…

    Highmark Health (Nashville, TN)
    …Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but ... (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment… more
    Highmark Health (12/20/24)
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  • Client Audit Specialist , Sr. - Remote

    Prime Therapeutics (Nashville, TN)
    …our passion and drives every decision we make. **Job Posting Title** Client Audit Specialist , Sr. - Remote **Job Description** The Client Audit Specialist Sr is ... regulatory, client, and/or functional audit expectations. The Client Audit Specialist Sr provides consultation and strategic advice regarding audit management… more
    Prime Therapeutics (01/01/25)
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  • Client Audit Specialist , Sr. - Remote

    Prime Therapeutics (Nashville, TN)
    …our passion and drives every decision we make. **Job Posting Title** Client Audit Specialist , Sr. - Remote **Job Description** As a member of the Client Audit ... Management (CAM) team, the Client Audit Specialist , Sr is accountable for managing regulatory and/or client-initiated audits. This role maintains a thorough… more
    Prime Therapeutics (01/07/25)
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  • Specialist , Credentialing Operations…

    Evolent (Nashville, TN)
    …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialist , Credentialing Operations will be a dynamic role that will encompass determining ... to the Associate Director, Credentialing Operations. **Collaboration Opportunities:** The Specialist , Credentialing Operations team collaborates with the Provider Data… more
    Evolent (12/05/24)
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  • Medical Billing Specialist

    TEKsystems (Goodlettsville, TN)
    Description Primary responsibilities will be working the Medicare /Medicaid AR accounts for a multi-physician Oncology practice. Including processing insurance ... claims, Medical Terminology, Insurance Verification, patient collections, HMO, PPO, Medi-cal, medicare insurance, medicaid Pay and Benefits The pay range for this… more
    TEKsystems (01/04/25)
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  • Medical Billing Specialist

    TEKsystems (Nashville, TN)
    Description Primary responsibilities will be working the Medicare /Medicaid AR accounts for a multi-physician Oncology practice. Including processing insurance ... develop. Understand concept of working and maintaining patient collections Familiar with Medicare , Medicaid, PPO, HMO and Third Party payer billing guidelines Strong… more
    TEKsystems (01/03/25)
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  • MDS Float

    Signature Healthcare (Nashville, TN)
    …facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great ... (RAI), Prospective Payment Systems (PPS), Quality Measures (QM's), Medicaid Casemix and Medicare guidelines for all SHC stakeholders. + Assist and collaborate with… more
    Signature Healthcare (11/27/24)
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  • Home Health RN Clinical Manager

    HCA Healthcare (Nashville, TN)
    …regarding deficiencies or OASIS corrections (with feedback from Quality Review Specialist ) to ensure the medical records reflect compliance with medical necessity, ... Two years of experience within a licensed and certified ( Medicare ) home health agency required + Competent in Federal...) home health agency required + Competent in Federal ( Medicare ) and Local standards including Conditions of Participation and… more
    HCA Healthcare (10/15/24)
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  • Nurse Practitioner PRN

    CenterWell (Madison, TN)
    …advanced practice professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist , Quality based Coder, Referral Coordinator and more. Our approach allows ... for TB. Preferred Qualifications: + Active and unrestricted DEA license + Medicare Provider Number/ Medicaid Provider Number + Experience managing Medicare more
    CenterWell (01/08/25)
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  • Nurse Practitioner

    CenterWell (Bellevue, TN)
    …advanced practice professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist , Quality based Coder, Referral Coordinator and more. Our approach allows ... for TB. **Preferred Qualifications:** + Active and unrestricted DEA license + Medicare Provider Number/ Medicaid Provider Number + Experience managing Medicare more
    CenterWell (10/30/24)
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  • Rx Clinical Programs Pharmacy Technician…

    CenterWell (Nashville, TN)
    …assignments. The Clinical Programs Pharmacy Technician Representative 2 Community Resource Specialist works within the Maximize Your Benefits department to assist ... government sponsored support such as Low Income Subsidy (LIS) and the Medicare Savings Program (MSP) for medication assistance. Works within defined parameters to… more
    CenterWell (01/10/25)
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  • Director of Regulatory - RN Required

    Signature Healthcare (Nashville, TN)
    …facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great ... survey team/team leader in compiling streamlined report. + Assist each facility's clinical specialist in formulating a plan of correction based on survey results, as… more
    Signature Healthcare (01/04/25)
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  • Outpatient Coder

    HCA Healthcare (Nashville, TN)
    …leadership + Works with team members in billing, revenue integrity and/or the Medicare Service Center to resolve alerts/edits + Communicates coding revisions to the ... Reasons + As needed, may periodically be asked to perform Coding Integrity Specialist II (CIS-II) duties + Periodically works with their Manager to review individual… more
    HCA Healthcare (11/13/24)
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  • Inpatient Coding Editor

    HCA Healthcare (Nashville, TN)
    …you to apply! **Job Summary and Qualifications** As an Inpatient Coding Specialist , you will be responsible for working inpatient coding related alerts/edits, ... leadership + Works with team members in billing, revenue integrity and/or the Medicare Service Center to resolve alerts/edits + Assigns interim DRGs for in-house… more
    HCA Healthcare (11/13/24)
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  • Activities Director

    Signature Healthcare (Clarksville, TN)
    …facilities have achieved a 4 or 5-star overall rating from the Centers for Medicare & Medicaid Services. Additionally, we have been awarded as a certified Great ... to make a Difference + Degree and certification as a therapeutic recreation specialist ; or + Certified Activity Director by the National Certification Council for… more
    Signature Healthcare (01/07/25)
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  • Billing Accountant Clerk

    Adecco US, Inc. (Hopkinsville, KY)
    Adecco is assisting a local client in filling an Accounting/Billing Specialist position in Hopkinsville, KY. You will obtain, review, and evaluate financial ... + High School graduate + 1 year experience with filing Medicare , Medicaid and/or Commercial Insurance claims and posting insurance remittances. Electronic… more
    Adecco US, Inc. (01/07/25)
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  • Inpatient Coder - REMOTE

    LifePoint Health (Brentwood, TN)
    …procedure codes utilizing ICD 10-CM/PCS codes according to the Centers for Medicare & Medicaid Services (CMS) requirements for hospital billing. Achieve and maintain ... in an acute care hospital is preferred. Certifications: Certified Coding Specialist (CCS) or Registered Health Information Technician (RHIT) preferred. **Job:**… more
    LifePoint Health (11/05/24)
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