NewGovernment Affairs Executive Sentry InsuranceGovernment Affairs ExecutiveNashville, TNExperience in a State DOI, and NAIC, or regulatory agency dealing with insurance financial services, state legislator or political campaign, think-tank public policy organization or trade association, corporate government relations department especially in the financial services industry . Developing and implementing strategic and advocacy plans for achieving public policy, legislative, and regulatory results in an assigned state and local market that are favorable to the organization and consistent with the overall legislative strategy.
Fleet Claims Specialist, Middle Mile Property Damage Amazon.com IncFleet Claims Specialist, Middle Mile Property DamageNashville, TNAn ideal candidate brings a background in fleet maintenance and automotive claims handling, with experience managing professional relationships with multiple stakeholders, holding responsible individuals accountable for asset damages and repair costs, and achieving organizational targets. Interact with carriers and customers to obtain facts, explain claims processes, and provide high quality service to achieve a positive customer experience.
Senior Claims Specialist - TN Workers'''' Compensation Great American Insurance CompanySenior Claims Specialist - TN Workers'''' CompensationTennessee, TN$95,000–$105,000 / yearWe take an extremely aggressive and proactive approach to claims adjusting and are looking for the person who not only knows their territory's comp laws but also enjoys the role of putting that experience to good use. Based in Cincinnati, Ohio, the operations of Great American Insurance Group are engaged primarily in property and casualty insurance focusing on specialty commercial products for businesses.
NewIndemnity Claims Specialist CorVel Enterprise Claims, Inc.Indemnity Claims SpecialistFranklin, TNRemote$52,999–$85,473 / yearPart timeThe Indemnity Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.
Indemnity Claims Specialist CorVel CorpIndemnity Claims SpecialistFranklin, TNRemote$52,999–$85,473 / yearESSENTIAL FUNCTIONS & RESPONSIBILITIES: • Receives claims, confirms policy coverage and acknowledgment of the claim • Determines validity and compensability of the claim • Establishes reserves and authorizes payments within reserving authority limits • Manages non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims under close supervision • Communicates claim status with the customer, claimant and client • Adheres to client and carrier guidelines and participates in claims review as needed • Assists other claims professionals with more complex or problematic claims as necessary • Additional duties as assigned. KNOWLEDGE & SKILLS: • Excellent written and verbal communication skills • Ability to learn rapidly to develop knowledge and understanding of claims practice • Ability to identify, analyze and solve problems • Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets • Strong interpersonal, time management and organizational skills • Ability to meet or exceed performance competencies • Ability to work both independently and within a team environment.
Senior Construction Defect Technical Claims Specialist Argo Group International Holdings IncSenior Construction Defect Technical Claims SpecialistTNRemote$137,496–$164,934 / yearBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area, including but limited to Albany county), Washington, D. C. Essential Responsibilities: Working under limited oversight under broad management direction, adjudicate construction defect claims at the highest authority limits on assignments reflecting the highest degree of technical complexity, potentially with major impact on departmental results.
Claims Specialist – Business Insurance Marsh McLennanClaims Specialist – Business InsuranceMaryville, TennesseeWith offices across North America, we combine the personalized service model of a local consultant with the global resources of the world’s leading professional services firm, Marsh (NYSE: MRSH). Marsh McLennan Agency (MMA) provides business insurance, employee health & benefits, retirement, and private client insurance solutions to organizations and individuals seeking limitless possibilities.
ESIS Senior Claims Specialist, WC Chubb LtdESIS Senior Claims Specialist, WCNashville, TN$71,000–$104,400 / yearAbility to plan, organize, and implement general business and people management practices, supported by completion of management and technical programs, business or legal coursework, or equivalent practical experience. With more than 70 years of experience, and offerings in both the U.S. and globally, ESIS provides one of the industrys broadest selections of risk management solutions covering both pre- and post-loss services.
Insurance Claims Specialist (Construction Defects and Property Damage) DPR Construction IncInsurance Claims Specialist (Construction Defects and Property Damage)Nashville, TNKey Skills: • Basic working knowledge and familiarity of: • Commercial General Liability • Property Insurance (Including Inland Marine and Builder's Risk) • Pollution Liability • Professional Liability • Controlled Insurance Programs (CCIP/OCIP) • RMIS Systems • Construction Industry Expertise • Strategic thinking • Strong written and oral communication skills • High level of EQ (Soft skills) • Self-Starter • Highly organized and responsive; ability to meet deadlines • Detail Oriented • Contractual risk assessment • Dispute management • Integrity • Ability to mentor and inspire others • Team player • Willingness to understand and advance the DPR Culture • Proactive Learner. Act as a liaison between all parties involved, including but not limited to, carriers, clients, trade partners, brokers, consultants, attorneys and DPR project teams (and DPR-related entities), as it relates to claim progress, strategy, expenses, and settlements.
Bodily Injury Claims Specialist Auto-Owners Insurance GroupBodily Injury Claims SpecialistJackson, TNThe position requires the person to: Assemble facts, determine coverage, evaluate the amount of loss, analyze legal liability, make payments in accordance with coverage, damage and liability determination, and perform other functions or duties to properly adjust the loss. Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs.
Electronic Data Interchange Claims Filing Specialist Nesco Resource, LLCElectronic Data Interchange Claims Filing SpecialistBrentwood, TN$18–$18 / hourThe EDI Claims Filing Specialist is responsible for ensuring that claims are accurately submitted to payors, either electronically or via paper, with all required documentation. Establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.
EDI Claims Filing Specialist Nesco Resource, LLCEDI Claims Filing SpecialistBrentwood, TN$18–$18 / hourThe EDI Claims Filing Specialist is responsible for ensuring that claims are accurately submitted to payors, either electronically or via paper, with all required documentation. Establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.
Senior Claims Benefit Specialist CVS Health CorpSenior Claims Benefit SpecialistWork At Home, TN$18.50–$42.35 / hourOur teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Review and adjust SF (self-funded), FI (fully insured), Reinsurance, and/or RX claims; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines.
NewClaims Escalation Specialist Fast Pace HealthClaims Escalation SpecialistTennesseeFull timeThe Claim Escalation Specialist will perform the daily collections and management of outstanding accounts, to include following up with insurance companies, reconciling accounts, filing corrected claims, appealing claims (when appropriate), and following up on all denials to ensure processing/reprocessing, and payments. Performs daily on collecting and managing of outstanding accounts, to include following up with insurance companies, reconciling accounts, filing corrected claims, appealing claims (when appropriate), and following up on all denials to ensure processing/reprocessing, and payments.
Claim Specialist - Property Field Inspection State FarmClaim Specialist - Property Field InspectionNashville, Tennessee$59,059.65–$90,000 / year37010 37015 37022 37029 37031 37032 37035 37040 37042 37043 37048 37049 37066 37072 37073 37075 37076 37080 37082 37115 37122 37138 37141 37143 37146 37148 37172 37181 37186 37187 37188 37189 37201 37203 37206 37207 37208 37209 37210 37212 37213 37214 37216 37218 37219 37228 37243. With the opportunity to initially earn up to 20 days annually plus parental leave, paid holidays, celebration day, life leave (40 hours/year), bereavement leave, and community service/education support days, there will be plenty of time for you!
Quality Control Specialist - Medicare Pharmacy Claims Health Care Service CorpQuality Control Specialist - Medicare Pharmacy ClaimsNashville, TNRemote$20.04–$44.61 / hourThe Quality Control Specialist conducts regular audits to verify adherence to regulations, internal policies, and operational procedures, while maintaining thorough documentation to support potential CMS program audits. Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work.
Regional Senior Casualty Claim Specialist - Litigation AAA Southern New EnglandRegional Senior Casualty Claim Specialist - LitigationTNBy continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals.
Field Claims Adjuster III, PL Property (Flex Team) Nationwide Mutual Insurance CoField Claims Adjuster III, PL Property (Flex Team)Nashville, TN$79,500–$148,500 / yearNationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. Qualifications: · 5 years of insurance field/property claims handling or adjusting experience · Solid experience/proficiency with Xactimate · Solid experience writing own estimates and handling claims start to finish · Strong customer service competency · Strong written & verbal communication skills.
Claims Adjuster II, Field Property - National Catastrophe Nationwide Mutual Insurance CoClaims Adjuster II, Field Property - National CatastropheNashville, TN$62,500–$115,500 / yearNationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. In this role, you'll conduct on-site inspections, evaluate property damages, determine policy coverage, and make timely, accurate decisions using a variety of tools and resources, including vendor estimates, independent adjusters, and self-written assessments.
Leave and Disability Claims Roles UNUM GroupLeave and Disability Claims RolesUSA, TN$22.12–$24.04 / hourWhether you’re directly supporting a growing family, or developing online tools to help navigate a difficult loss, customers are counting on the combined talents of our entire team. When you apply, you'll be considered for positions such as Integrated Paid Leave Specialist, STD Benefits Specialist Trainee, Associate Leave Specialist, Eligibility Specialist and Associate Life Event Specialist.
Auto Claims Appraiser Sentry Insurance GroupAuto Claims AppraiserNashville, TNLead efficient claim decisions by assessing losses, building estimates, and securing fair settlements while collaborating with repair teams and tracking the latest repair technology. Knowledge of vehicle repairs gained from previous experience in a repair facility, appraising responsibilities, or collision repair course work preferred.
Managing Director Property Claims HCA HealthcareManaging Director Property ClaimsNashville, TNMajor Responsibilities: Proactively manage system-wide property claims including oversight of between HCA facility contacts, corporate functional areas, Third Party Administrator (TPA), forensic accountants, broker claims representative and captive insurer/fronting parties. This includes oversight of HCA’s property claims handling via coordination between HCA facility contacts, corporate functional areas, Third Party Administrator (TPA), forensic accountants, broker claims representative and captive insurer/fronting parties.
Fraud Protection Services - Claim Resolution Specialist First Horizon CorpFraud Protection Services - Claim Resolution SpecialistMaryville, TNAligned with our core values-client focus, caring for people, commitment to excellence, expanding access, and fostering team success-our specialists play a key role in upholding the integrity of our operations and strengthening relationships with both internal and external clients. Headquartered in Memphis, TN, the banking subsidiary First Horizon Bank operates in 12 states across the southern U.S. First Horizon has been recognized as one of the nation's best employers by Fortune and Forbes magazines and a Top 10 Most Reputable U.S. Bank.
Claim Benefit Specialist CVS Health CorpClaim Benefit SpecialistWork At Home, TN$17–$28.46 / hourAnalyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department. Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing.
Claim Benefit Specialist Operations CVS Health CorpClaim Benefit Specialist OperationsFranklin, TN$17–$28.46 / hourPerforms claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing. Analyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department.
Sr Claims Reviewer TriWest Healthcare AllianceSr Claims ReviewerNashville, TNRemoteFull timeProficient with claim and coding tools such as Supercoder, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding. This role will serve as a SME and will collaborate with Claims leadership, Training, the Claims Content Specialist, and internal business partners to ensure procedures and training materials are accurate and complete.
NewTemporary Subrogation Claim Support Processor AAA Southern New EnglandTemporary Subrogation Claim Support ProcessorTN$15–$20 / hourBy continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. This position also provides support to CR1 staff during periods of high volume, which includes compiling claim packets and referring eligible claims with supporting documentation to collection vendors, excluding claims involving total losses.
NewEntry-Level Medical Billing Specialist ReveljobsEntry-Level Medical Billing SpecialistMemphis, TennesseeThe Entry-Level Medical Billing Specialist will assist with preparing and reviewing insurance claims, updating patient and insurance information, supporting basic billing and coding processes, and helping patients with billing-related questions. A confidential healthcare organization is seeking a detail-oriented Entry-Level Medical Billing Specialist to support medical billing, insurance claims, patient account questions, coding-related workflows, and general administrative functions.
Billing Specialist/Insurance Collector Acadia Healthcare Co IncBilling Specialist/Insurance CollectorChattanooga, TN$19–$24 / hourIf you''re passionate about making a difference in the lives of those in need through compassionate therapeutic practices and thrive in a supportive team environment that fosters learning and growth, this position is perfect for you! Gather and interpret data from system and understands appropriate course of action to take and initiates time-sensitive and strategic steps resulting in payment.
Revenue Specialist, First Party Auto, MVA EnableComp LLCRevenue Specialist, First Party Auto, MVAFranklin, TNEnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers (ASCs) nationwide. Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert human-in-the-loop integration, EnableComp provides solutions across the revenue lifecycle for Veterans Administration, Workers' Compensation, Motor Vehicle Accidents, and Out-of-State Medicaid claims as well as denials for all payer classes.
Account Reimbursement Specialist TwelveStone Health PartnersAccount Reimbursement SpecialistMurfreesboro, TNChronic conditions include Multiple Sclerosis, NMOSD, Myasthenia Gravis, CIDP, ITP, Migraine Prevention, Crohn's Disease, Ulcerative Colitis, Plaque Psoriasis, Alpha 1 Antitrypsin Deficiency, Primary Immunodeficiency, hATTR Amyloidosis, Thyroid Eye Disease, and many others. Functional Competencies: Denials processing, claims, ability to handle multiple priority and tasks, strong attention to detail, strong verbal and written communication skills, analytical skills, computer skills (Outlook, Excel, Word, etc.).
Insurance Follow-Up Specialist IVX HealthInsurance Follow-Up SpecialistBrentwood, TNRemote$22–$25 / hourOur Insurance Follow Up Specialists are a vital part of the patient care journey, ensuring that every claim is handled with precision, empathy, and a clear understanding of how billing impacts both access to care and peace of mind. IVX Health is a national provider of infusion and injection therapy for individuals managing complex chronic conditions like rheumatoid arthritis, Crohn's disease, and multiple sclerosis.
Specialist-Billing Baptist Memorial Health Care CorpSpecialist-BillingMemphis, TNResponsible for the daily completion of both cliams edit, denial, and no response billing functions for timely follow up. Bills, collects and submits all insurance and TPA claims according to payer guidelines, and established procedures and workflows.
Medicare Risk Adjustment Coding Specialist- Remote American Health Companies IncMedicare Risk Adjustment Coding Specialist- RemoteFranklin, TNRemoteReview medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries to verify accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered. JOB REQUIREMENTS: Maintain a high level of familiarity of current CMS regulations and announcements affecting risk adjustment to include the review of regulatory announcements via educational sessions provided by regulatory entities and educational opportunities within the industry.
Patient Account Representative, Fort Sanders Women''s Specialists Covenant HealthPatient Account Representative, Fort Sanders Women''s SpecialistsKnoxville, TNConducts in-office collection activities including reviewing accounts prior to office visits, establishing delivery contracts with patients, explaining accounts to patients and setting up payment plans. None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED.
Revenue Specialist, VA EnableCompRevenue Specialist, VAUnited States - Remote, TennesseeRemoteEnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM. Research, request and acquire all pertinent medical records and any other supporting documentation necessary and then submit with hospital claims to the Veterans Administration or TriWest to ensure prompt correct claims reimbursement.
Revenue Specialist, Third Party Auto, MVA EnableCompRevenue Specialist, Third Party Auto, MVAUnited States - Remote, TennesseeRemoteThe Revenue Specialist, Third-Party Claims investigates and analyzes Motor Vehicle Accident accounts in order to properly identify and coordinate insurance benefits and resolve outstanding balances for our clients. EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM.
Revenue Specialist, VA EnableComp LLCRevenue Specialist, VAFranklin, TNEnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers (ASCs) nationwide. Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert human-in-the-loop integration, EnableComp provides solutions across the revenue lifecycle for Veterans Administration, Workers Compensation, Motor Vehicle Accidents, and Out-of-State Medicaid claims as well as denials for all payer classes.
Revenue Specialist, Third Party Auto, MVA EnableComp LLCRevenue Specialist, Third Party Auto, MVAFranklin, TNEnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers (ASCs) nationwide. Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert human-in-the-loop integration, EnableComp provides solutions across the revenue lifecycle for Veterans Administration, Workers' Compensation, Motor Vehicle Accidents, and Out-of-State Medicaid claims as well as denials for all payer classes.
Appeals Specialist Medical Data SystemsAppeals SpecialistTennesseeEssential DutiesComplete insurance-related tasks such as correcting and resubmitting claims, filing appeals, and contacting insurance companies, attorneys, or patients regarding outstanding balances. Proficient knowledge of insurance processes, including claim submission, claim denials, HCPCS/CPT/ICD-10 coding basics, and claim status inquiries.
Medical Billing / Coding Representative - University Cancer Specialists University Physicians Association IncMedical Billing / Coding Representative - University Cancer SpecialistsAlcoa, TNUniversity Physicians' Association is looking for a full-time Medical Billing / Coding Representative for University Cancer Specialists located in Alcoa, TN. REQUIRED EDUCATION & TRAINING: Requires High School education or equivalency, medical billing courses or college preferred.
NewBilling Specialist Guardian PharmacyBilling SpecialistMemphis, TNOur core focus is delivering customized medication management solutions to support healthcare organizations serving seniors and individuals with complex care needs. With our comprehensive suite of tech-enabled pharmacy services and a dedicated team of professionals committed to enriching the lives of those we serve, we are redefining how pharmacy care is delivered.
Billing Specialist Tailored ManagementBilling SpecialistNashville, TNRemote$22–$22 / hourThis role is responsible for preparing and submitting claims, resolving billing issues, and ensuring accurate and timely reimbursement while maintaining compliance with payer and regulatory requirements. We are seeking a detail-oriented Billing Specialist to support Revenue Cycle Management (RCM) operations for Urology, Radiation Oncology, and Imaging services.
Collections Specialist Work from Home HCA Healthcare IncCollections Specialist Work from HomeNashville, TNWhat you will do in this role:You will perform follow up activities on accounts to ensure prompt paymentYou will identify coding or billing errors from EOBs and work to correct themYou will monitor insurance claims and contact insurance companies to resolve claims You will update the patient account record to identify actions takenYou will assign bad debt accounts to the collection agency You will act as a liaison and administer contracts in collection of third party accounts (Medicare and Medicaid)You will complete account reconciliation of accounts turned over to outside agenciesYou will negotiate payment plans on self-pay accounts You are responsible for maintaining accounts receivable and creating a reduction in bad debt Qualifications you will need:Minimum (1) year of experience in a medical office setting highly preferred. Under the supervision of the Business Office Manager/Business Office Supervisor, you will obtain payment from third party payers and self-pay accounts to enhance cash flow and gather reimbursement based on established contracts.
Payer Enrollment Specialist Vanderbilt University Medical CenterPayer Enrollment SpecialistNashville, TNProblem Solving (Intermediate): Uses critical thinking and process improvement, i.e., coaches and mentors develop a problem statement, describes the current state, identify root causes, create future state, coaches, and mentors develop solutions and action plans with a sustainability plan. Discover Vanderbilt University Medical Center: Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world.
Collections Specialist HCA Healthcare IncCollections SpecialistNashville, TNWhat you will do in this role: You will perform follow up activities on accounts to ensure prompt payment You will identify coding or billing errors from EOBs and work to correct them You will monitor insurance claims and contact insurance companies to resolve claims You will update the patient account record to identify actions taken You will assign bad debt to the collection agency You will act as a liaison accounts and administer contracts in collection of third party accounts (Medicare and Medicaid) You will complete account reconciliation of accounts turned over to outside agencies You will negotiate payment plans on self-pay accounts You are responsible for maintaining accounts receivable and creating a reduction in bad debt Qualifications you will need: Minimum (1) year of experience in a medical office setting highly preferred. Under the supervision of the Business Office Manager/Business Office Supervisor, you will obtain payment from third party payers and self-pay accounts to enhance cash flow and gather reimbursement based on established contracts.
Specialist-Denial I Baptist Memorial Health Care CorpSpecialist-Denial IMemphis, TNCompiles, analyzes, and distributes necessary clinical and financial information and presents reports to other healthcare providers in order to improve performances and increase awareness of resources consumed related to reimbursement. Specialist-Denial I Job ID: 39524 Job Category: Billing, Claims and Revenue Work Type: Full Time Work Schedule: Days Department: Denial Mitigation Facility: BMHCC System Services Location: Memphis, TN.
Specialist-Payer Enrollment-FT days Baptist Memorial Health Care CorpSpecialist-Payer Enrollment-FT daysTNFollow up with payers to ensure timely and accurate processing of provider enrollments within payer-specific turnaround time metrics, communicating directly with payer representatives to resolve enrollment issues or discrepancies, and escalating trends or new payer requirements to leadership. Complete timely revalidation through payer portals, recredentialing applications, or profiles such as CAQH to ensure that providers maintain enrollment with commercial and governmental payers.
Insurance Specialist Tennessee Cancer SpecialistsInsurance SpecialistKnoxville, TennesseeMINIMUM QUALIFICATIONS • High School diploma or equivalent required • Minimum two (2) years combined medical billing and payment experience required • Demonstrate knowledge of state, federal, and third party claims processing required • Demonstrate knowledge of state & federal collections guidelines • Must successfully complete required e-learning courses within 90 days of occupying position PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. You will need sufficient manual dexterity for operating office equipment (keyboard, telephone, copier, etc.), and vision and hearing must be adequate for viewing computer screens for prolonged periods of time and hearing customers during in-person and telephone conversations.
Revenue Cycle Specialist Acadia Healthcare Co IncRevenue Cycle SpecialistFranklin, TNValidates all necessary referrals/prior authorizations/pre-certifications for scheduled services are on file and shared with all appropriate staff and are valid for the scheduled services performed. Work daily claims rejection lists including but not limited to; claims rejected due to auto eligibility process during weekly billing and "Rejected" claims due to eligibility, coordination of care and authorization as part of accounts receivable.