- Prime Therapeutics (Nashville, TN)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Appeals Coordinator **Job Description** + Maintains a caseload and monitors day to ... medical necessity reviews. + Enters all data related to appeals and case reviews into a database. + Prepares...into a database. + Prepares and presents information on appeals to panels second-level multi-disciplinary committee. + Participates in… more
- Baptist Memorial (Memphis, TN)
- Summary Medicare / Medicaid Appeals Registered Nurse reviews and evaluates medical documentation to support billing compliance and external regulatory requirements. ... Responsibilities + Abstracts pertinent information from the medical record to create appeals for cases denied by governmental payors. + Educates department staff to… more
- Cardinal Health (Nashville, TN)
- …to Cardinal Health_** The Sr. Coord, Individualized Care (Reimbursement Coordinator ) supports patient access to therapy through Reimbursement Support Services ... * Follow through on all benefit investigation rejections, including Prior Authorizations, Appeals , etc. All avenues to obtain coverage for the product must be… more
- Cardinal Health (Nashville, TN)
- …documenting patient health insurance benefit investigations, prior authorizations, and appeals , preferred + Knowledge of Medicare, Medicaid and Commercially insured ... payer common practices and policies, preferred + Critical and creative thinking, preferred + Knowledge of the Health Insurance Market Place and the Affordable Care Act preferred + Knowledge of Medical/Pharmacy billing and coding is preferred + Important to… more
- Cardinal Health (Nashville, TN)
- …Events and follow process for timely submission. Review all requests for appeals and ensure supporting documentation is present. Support team with call overflow ... when needed. Ability to mediate situations in which parties are in disagreement and facilitate a positive outcome. Effectively be able to multitask daily tasks and workload. + **TRAINING AND WORK SCHEDULES** : Your new hire training will take place… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Coordinator Registration, Admitting & Registration Full Time, 80 Hours per pay period, Night Shift Parkwest Overview: Since admitting our first patient in ... to Inpatient Admitting, Outpatient Registration, Financial Counseling, Cashier, Customer Service/ Appeals and Outpatient Pre-Certification. Provides leadership to all personnel… more
- Covenant Health Inc. (Morristown, TN)
- …and leadership to resolve employee relations issues. + Acts as special projects coordinator and leader on various HR projects as needed. + Conducts training programs ... Tennessee Department of Employment Security Claims and represents Covenant Health on appeals . + Conducts follow up regarding findings from Compensation, HRIS, or… more