- HCA Healthcare (Nashville, TN)
- …Eligible* Do you have the career opportunities as an Inpatient Coding Denial Specialist you want with your current employer? We have an exciting opportunity for ... group of colleagues. Do you want to work as an Inpatient Coding Denial Specialist where your passion for creating positive patient interactions is valued? If you are… more
- 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
- 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 (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
- 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
- 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 (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
- Community Health Systems (Franklin, TN)
- …and value-based quality programs. This includes but is not limited to Medicare Traditional and Advantage, Commercial, governmental, ACO, BPCI, CJR, and other ... quality-related and value-based reimbursement programs. + Partner with assigned practices to train clinicians and office staff on workflows to incorporate into their daily activities that drive toward outcomes in the practice that improve care and reduce… more
- 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
- 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
- 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
- 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
- Catholic Health Initiatives (Chattanooga, TN)
- …and evidence based practice guidelines. Certified Diabetes Care and Education Specialist or BC-ADM credential preferred/eligible. If not already DCES or BC-ADM ... within 24 months of hire date. + Knowledge of Medicaid, Medicare Advantage Plans and Medicare Part B - PREFERRED + Diabetes self-management education and support… more
- Humana (Memphis, TN)
- …a part of our caring community and help us put health first** The Technician Specialist is a certified Pharmacy Technician who acts as an intake for all calls from ... patients, pharmacies and providers. The Technician Specialist performs advanced administrative/operational/customer support duties that require independent… more
- Banner Health (TN)
- …and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health ... least one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician (CCS-P), Certified… more
- Community Health Systems (Franklin, TN)
- (Full time, Remote) A Sales and Use Tax Specialist is responsible for filing tax returns, remittance of tax payments, and meeting statutory deadlines within the P2P ... Ensuring compliance with accounting principles and regulations, including HIPAA, Medicare , and Medicaid regulations. + **Record keeping:** Provides assistance with… more
- 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 (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
- Aveanna (Knoxville, TN)
- …per hour Position Details JOB DESCRIPTION SUMMARY: The AveannaCare Specialist /Coordinator is responsible for assisting the AveannaCare users (participants, clients, ... environment 8. Bilingual in Spanish, preferred As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements… more
- Covenant Health Inc. (Knoxville, TN)
- …disciplinary process as appropriate. + Collaborates with Medical Record Specialist for monitoring completeness/correctness and timeliness of OASIS survey submission. ... broad experience in use of high tech equipment; knowledge of Medicare guidelines. Excellent communication skills; Conflict resolution skills; Effective teambuilding… more