• Sr Compliance RCM & Coding Auditor

    Humana (Nashville, TN)
    …business partners to uphold ethical standards and mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance , by ... about 340+ senior focused primary care centers in 15 states. The Regulatory Compliance team that supports the PCO is responsibility to assess, investigate, audit and… more
    Humana (07/29/25)
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  • Remote Physician Pro Fee Coding Specialist…

    Community Health Systems (Franklin, TN)
    …data, adhering to HIPAA and corporate compliance policies. + Escalates documentation or coding issues to the coding education team for provider training ... integrity, and working collaboratively with internal teams to support physician coding compliance and reimbursement. **Essential Functions** + Assigns accurate… more
    Community Health Systems (08/02/25)
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  • Coding Spec-Clinic

    Covenant Health Inc. (Knoxville, TN)
    …directly with the physicians, Manager of Corporate Coding Services, Director of Registration/Admitting, and medical staff education efforts, serves as ... per UB 92 or HCFA 1500 form. + Provides education to coding staff and physicians in...awareness of compliance as it relates to coding and documentation. + Facilitates and coordinates education more
    Covenant Health Inc. (06/14/25)
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  • Medical Director - Florida

    Humana (Nashville, TN)
    …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
    Humana (07/29/25)
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  • Medical Director - South Carolina SE Region

    Humana (Nashville, TN)
    …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director ... requires an in-depth evaluation of variable factors. **Description** The Medical Director actively uses their medical background, experience, and judgement to make… more
    Humana (07/22/25)
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  • Medical Director - Mid West Region

    Humana (Nashville, TN)
    …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national… more
    Humana (05/14/25)
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  • Associate Medical Director , PVRM

    Sumitomo Pharma (Nashville, TN)
    …highly motivated, and experienced individual for the position of **Associate Medical Director .** The Associate Medical Director will provide hands-on PVRM ... assessment of ICSRs, including seriousness, expectedness, safety narratives, adverse event coding , concomitant medication coding , and causality statements. +… more
    Sumitomo Pharma (08/02/25)
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  • Clinical Documentation and Claims Integrity…

    Elevance Health (Nashville, TN)
    **Clinical Documentation and Claims Integrity Director ** **Location:** Alternate locations may be considered. This position will work a hybrid model (remote and ... home-care and community based services. The **Clinical Document Improvement Director ** is responsible for leading encounter processing, diagnostic documentation and… more
    Elevance Health (07/18/25)
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  • Director -Health Information Management

    Baptist Memorial (Union City, TN)
    Director is responsible for facility-wide oversight of the compliance with regulatory and accreditation standards associated with Health Information Management, ... Overview Job Summary The Director of Health Information Management provides overall management and strategic leadership of the Health Information Management programs… more
    Baptist Memorial (06/20/25)
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  • Physician Education Specialist

    Community Health Systems (Franklin, TN)
    …training and education to CHS-affiliated providers and staff on accurate coding and documentation to ensure compliance with federal, state, and local ... in developing, updating, and maintaining educational materials and resources to support compliance with coding and documentation regulations. + Remains current… more
    Community Health Systems (07/12/25)
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