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We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. CGS has been a proven provider of administrative and business services for state Medicaid agencies, managed care organizations, commercial health plans, Medicaid members, Medicare beneficiaries, healthcare providers, and medical equipment suppliers for more than 50 years.

CGS Administrators

Appeals Specialist

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As one of the nation''s leaders in treating individuals with acute co-occurring mood, addiction, and trauma, Acadia Healthcare places a strong emphasis on our admissions & intake functions to allow us to help every possible person in need. Licensure, as required for the area of clinical specialty, i.e., RN license, CAC or other clinical counseling or therapy license, as designated by the state in which the facility operates.

Acadia Healthcare Co Inc

Admissions Services Specialist Acute

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More information on the CDPH HMDR program and approved training options can be found here: https://www.cdph.ca.gov/Programs/CEH/DFDCS/Pages/FDBPrograms/HomeMedicalDeviceRetailProgram.aspx . This license requires completion of state-approved training and a course completion certificate, as HMDR facilities are required to have an Exemptee physically present during all hours of operation in lieu of a pharmacist.

AdaptHealth Corp

Operations Specialist Non-Driving

Across North America, we help clients enhance workplace experiences and business operations through services including workplace support, physical and digital mailroom solutions, intelligent document processing, reception and concierge services, and other business support offerings. The Field Support Specialist/Mailroom Specialist provides exceptional office and mail services in a “floating” capacity for positions where regular employees normally work but are out of office, or if particular projects require additional coverage.

Office Services Specialist (On-Call)

Established 1976 in Nashville, Tennessee Oncology's mission remains unchanged: To provide access to high-quality cancer care and the expertise of clinical research for all patients, at convenient locations within their community and close to their home. Tennessee Oncology, one of the nation's largest, community-based cancer care specialists, is home to one of the leading clinical trial networks in the country.

Tennessee Oncology, one of the nation’s largest, community-based cancer care specialists, is home to one of the leading clinical trial networks in the country. 
Established 1976 in Nashville, Tennessee Oncology’s mission remains unchanged: To provide access to high-quality cancer care and the expertise of clinical research for all patients, at convenient locations within their community and close to their home. Our growing network of physicians and locations is based on this mission. 
We provide on-site chemotherapy treatments at over thirty locations, so patients may receive the necessary care without the strain of long-distance travel. 
Tennessee Oncology is committed to advancing both the science of detection and targeted treatments, and to making these advances available to every patient. We believe caring for cancer patients is a privilege.

Tennesssee Oncology

HIM Specialist (Float)

5–7+ years of Life Insurance claims experience required, including adjudication of complex claims such as contestability reviews, exclusions, beneficiary disputes, Demonstrated expertise in investigating, evaluating, and adjudicating life insurance claims from initial notice through claims decision in accordance with policy provisions and company guidelines. Strong communication skills with the ability to effectively engage with beneficiaries, funeral homes, attorneys, medical providers, and internal partners, delivering clear, timely, and compassionate communication throughout the claims process.

Pacific Life

Senior Life Claims Specialist

Prepare correct Workers’ Comp initial bill packet or appeal letter using EnableComp systems tools and submit with all necessary supporting documentation to insurance companies. Research, request and acquire all pertinent medical records, implant manufacturer’s invoices and any other supporting documentation necessary and then submit with hospital claims to insurance companies to ensure prompt correct claims reimbursement.

EnableComp

Revenue Specialist, Worker's Compensation (REMOTE)

Where appropriate, Company-provided benefit plans such as comprehensive leave, holiday, medical, dental, life, accident, disability coverages, retirement plan contributions, and other health and welfare benefits and payments are utilized to meet these obligations. Leidos QTC Health Services collaborates closely with government and non-government customers to address current and future program needs within the health services domain.

Leidos QTC Health Services

Biomedical Technician Specialist

Incumbents demonstrate an understanding of regulatory and compliance landscape related to supplemental health benefits and partners with Compliance, Legal and Support Services to resolve issues in a timely manner. The ideal candidate combines strong technical expertise, regulatory knowledge, critical thinking, and compassion while helping customers navigate important life events.

YEAR

Senior Long Term Disability Claims Specialist

EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM . The Revenue Specialist, Medicaid ensures proper submission and adjudication of all claims submitted to Medicaid carriers while working within the deadlines and protocols of the assignments.

Revenue Specialist, OSM

AdaptHealth

Operations Specialist

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BioMed Technician Specialist

In accordance with California law, candidates applying for positions located in California that require on-site presence at a Home Medical Device Retailer (HMDR) facility must obtain a California Department of Public Health (CDPH) Exemptee License. This license requires completion of state-approved training and a course completion certificate, as HMDR facilities are required to have an Exemptee physically present during all hours of operation in lieu of a pharmacist.

Documentation Specialist

Based in Mooresville, N.C., Lowe's supports the communities it serves through programs focused on creating safe, affordable housing, improving community spaces, helping to develop the next generation of skilled trade experts and providing disaster relief to communities in need. Serve as a point of contact for customers and vendors within your department, providing project estimates, scheduling installer visits, processing and tracking customer orders/installations, and following up to ensure project completion.

Lowe's Home Centers

Full Time - Sales Specialist - Flooring - Day

HIM Specialist

Research, request, acquire, and review medical records, provider notes, explanation of benefits and any other supporting documentation necessary for knowledge of appeal or account information, and then submit with hospital claims to insurance companies to ensure prompt correct claims reimbursement. EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM POSITION SUMMARY .

Revenue Specialist, MVA

Periodically works with their Manager to review individual work accomplishments, discuss work problems/barriers, discuss progress in mastering tasks and work processes, and discusses individual training needs and career progression. The Coding Account Resolution Specialist-III (CARS-III) works inpatient coding related alerts/edits, predominately post initial/final coding.

At its founding in 1968, Nashville-based HCA was one of the nation's first hospital companies. Today, we are the nation's leading provider of healthcare services, a company comprised of locally managed facilities that includes about 165 hospitals and 115 freestanding surgery centers in 20 states and England and employing approximately 204,000 people. Approximately four to five percent of all inpatient care delivered in the country today is provided by HCA facilities. Richard M. Bracken serves as Chairman of HCA and R. Milton Johnson is the company's President and Chief Executive Officer. HCA is committed to the care and improvement of human life and strives to deliver high quality, cost effective healthcare in the communities we serve. Building on the foundation provided by our Mission & Values, HCA puts patients first and works to constantly improve the care we give them by implementing measures that support our caregivers, help ensure patient safety and provide the highest possible quality. Investing in our communities is important to us. HCA typically invests about $1.5 billion annually to keep our facilities modern and up-to-date technologically and to expand and add services where needed. Focusing primarily on communities where the company is a leading healthcare provider, HCA selectively adds new facilities in order to better serve our communities. And because two HCA founders were physicians, we value highly the strong relationships we've created with local physicians. We endeavor to provide them with a wide array of services and modern facilities in order to help them deliver the best possible care.

HCA Healthcare

Inpatient Coding Resolution Specialist

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Please note that this role is not available to candidates in Alaska, Maine, Washington DC, New Jersey, California, New York, Massachusetts, Connecticut, Colorado, Washington State, Oregon, or Minnesota. From limited local options and long wait times to treatment that lacks personalization, behavioral healthcare can leave people feeling unseen and unsupported.

Charlie Health Inc

Insurance Verification Specialist

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. Maintain Board Certification by a specialty board approved by the American Board of Medical Specialties, National Board of Physicians and Surgeons, or the Advisory Board of Osteopathic Specialists.

Medical Review Specialist Jobs in Nashville, TN

Appeals Specialist CGS Administrators

Admissions Services Specialist Acute Acadia Healthcare Co Inc

Operations Specialist Non-Driving AdaptHealth Corp

Office Services Specialist (On-Call) SPS

HIM Specialist (Float) Tennesssee Oncology

Senior Life Claims Specialist Pacific Life

Revenue Specialist, Worker's Compensation (REMOTE) EnableComp

Biomedical Technician Specialist Leidos QTC Health Services

Senior Long Term Disability Claims Specialist Pacific Life

Revenue Specialist, OSM EnableComp

Operations Specialist AdaptHealth

BioMed Technician Specialist Leidos QTC Health Services

Documentation Specialist AdaptHealth

Full Time - Sales Specialist - Flooring - Day Lowe's Home Centers

HIM Specialist Tennesssee Oncology

Operations Specialist Non-Driving AdaptHealth

Revenue Specialist, MVA EnableComp

Inpatient Coding Resolution Specialist HCA Healthcare

Insurance Verification Specialist Charlie Health Inc

Medical Director, General Surgery (Remote) Health Care Service Corp

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