- CVS Health (Nashville, TN)
- …it all with heart, each and every day. **A Brief Overview** The Lead Director , Provider Data Compliance is responsible for overseeing the compliance of provider data ... with Compliance, Legal, Medicaid Health Plans, Network Contracting, and Provider Relations to ensure alignment with regulatory and contractual obligations. The Lead… more
- Highmark Health (Nashville, TN)
- …both the return on investment (ROI) and other decisions on the payer partnership constructs. These new approaches require new operational capabilities, and this ... leaders. Serve as a subject matter expert working in concert with provider relations and clinical transformation consultants to explain new programs and results to… more
- Covenant Health Inc. (Knoxville, TN)
- …medicine and urology. Position Summary: Demonstrates knowledge of Medicare and payer billing guidelines and policies. Demonstrates ability to promptly review, ... interpret and communicate current and changes to published Medicare and other payer billing guidelines/policies. The Billing Liaison must be able to answer policy… more
- Sanofi Group (Nashville, TN)
- …customers. In this field-based position, the FRM will report to a field-based Director , Field Reimbursement, within Patient Support for T1D (Type 1 Diabetes). The ... billing and coding, financial assistance offerings, patient support, access, payer medical policy, prior authorization, specialty pharmacy operations, infusion… more
- Community Health Systems (Franklin, TN)
- …in care management preferred + 1-2 years of experience in utilization management, payer relations , or hospital revenue cycle preferred **Knowledge, Skills and ... hospital resource utilization, reduce readmissions, and maintain compliance with payer requirements. **Essential Functions** + Performs admission and continued stay… more
- Covenant Health Inc. (Knoxville, TN)
- …cashiering, etc.) + Responsible for Patient Accounting system master file integrity, payer monitoring, and customer relations . + Remain current on procedural ... Overview Patient Accounting Director , Business Office Full Time, 80 Hours Per...problems that arise routinely within responsibility area. Examples Include: payer delays; patient complaints; serious computer problems; legal Issues;… more
- Covenant Health Inc. (Knoxville, TN)
- …course of action for proper resolution. + Responsible for learning & understanding payer rules, as well as state/federal guidelines. + Responsible for prioritizing & ... guidelines, HCFA guidelines, TennCare guidelines and other Third Party Payer requirements assuring departmental compliance. + Recognizes situations, which… more
- Covenant Health Inc. (Knoxville, TN)
- …Assists other departments as needed and meets other requests of the Director and Vice-President of Financial Services. Recruiter: Suzie McGuinn || ###@covhlth.com ... + Performs other duties as assigned to the satisfaction of the Manager, Director and/or Vice-President of Financial Services. + Supports, models and adheres to the… more
- Covenant Health Inc. (Knoxville, TN)
- …guidelines, HCFA guidelines, TennCare guidelines and other Third Party Payer requirements assuring departmental compliance. + Recognizes situations, which ... program and safety standards. + Demonstrates an ability to understand the payer requirements of insurance carriers. + Demonstrates an understanding of all patient… more
- Covenant Health Inc. (Knoxville, TN)
- …guidelines, HCFA guidelines, TennCare guidelines and other Third Party Payer requirements assuring departmental compliance. + Recognizes situations, which ... program and safety standards + Demonstrates an ability to understand the payer requirements of insurance carriers. + Demonstrates an understanding of all patient… more