• Specialist-Denial II RN

    Baptist Memorial (Memphis, TN)
    …Nursing, Case Management or Denial Management. Familiarity with electronic medical records and claims/practice management systems. Requires critical ... to obtain additional documentation to support appeal, collaborate with coding /billing for formulation of appeal with corrected claims and...the entire appeal process and determines if escalation to manager or payer is next step to get a… more
    Baptist Memorial (04/12/25)
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  • Specialist-Denial II RN

    Baptist Memorial (Memphis, TN)
    …Required: Nursing, Case Management or Denial Management. Familiarity with electronic medical records and claims/practice management systems. Requires critical ... to obtain additional documentation to support appeal, collaborate with coding /billing for formulation of appeal with corrected claims and...the entire appeal process and determines if escalation to manager or payer is next step to get a… more
    Baptist Memorial (04/11/25)
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  • Nurse Reviewer I

    Elevance Health (Brentwood, TN)
    …_A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a benefit-management leader in ... Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. Partners… more
    Elevance Health (05/15/25)
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  • CenterWell - Physician - Nashville

    CenterWell (Hermitage, TN)
    …Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators ... accordance with standards of care. + Follows level of medical care and quality for patients and monitors care...manner working with a quality- based coder to optimize coding specificity. + Follows policy and protocol defined by… more
    CenterWell (05/10/25)
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  • Primary Care Physician

    CenterWell (Nashville, TN)
    …Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators ... accordance with standards of care. . Follows level of medical care and quality for patients and monitors care...manner working with a quality- based coder to optimize coding specificity. . Follows policy and protocol defined by… more
    CenterWell (05/08/25)
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  • PT Account Rep I-Clinic

    Covenant Health Inc. (Knoxville, TN)
    …and billing process. Recruiter: Sarah Grey || ###@covhlth.com|| ### Responsibilities + Reviews medical records to ensure that ICD-9 and CPT codes are used ... delivered over 26,000 high-risk babies at Fort Sanders Regional Medical Center. We offer a range of care services...in accordance with coding and reimbursement guidelines. + Ensures that charges for… more
    Covenant Health Inc. (03/05/25)
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  • Nurse Practitioner

    CenterWell (Bellevue, TN)
    …treats center patients in accordance with standards of care. . Follows level of medical care and quality for patients and monitors care using available data and ... limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care. . Acts as...manner working with a quality- based coder to optimize coding specificity. . Follows policy and protocol defined by… more
    CenterWell (05/17/25)
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  • PRN RN Home Health

    HCA Healthcare (Nashville, TN)
    …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision...physician's orders and under the supervision of the Clinical Manager . **What you will do in this role:** +… more
    HCA Healthcare (04/16/25)
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  • Nurse Practitioner PRN

    CenterWell (Madison, TN)
    …treats center patients in accordance with standards of care. . Follows level of medical care and quality for patients and monitors care using available data and ... limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care. . Acts as...manner working with a quality- based coder to optimize coding specificity. . Follows policy and protocol defined by… more
    CenterWell (04/09/25)
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  • Pharmacist - Clinical Operations Advisor

    CVS Health (Nashville, TN)
    …plan. The Clinical Operations Advisor works with the Benefit Relationship Manager and client to facilitate gathering formulary and utilization management ... Advisor designs the clinical setups using Caremark technology solutions and supports the coding teams in the loading of clinical data into the adjudication system.… more
    CVS Health (05/16/25)
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