- CVS Health (Nashville, TN)
- …/ Appeal Hearings / Special Projects and Committee participation when needed. The Medical Director will provide clinical, coding , and reimbursement expertise ... Internal Medicine / Pediatrics (Med / Peds) Board Certification. In the Medical Director role, you will provide oversight for medical policy implementation.… more
- HCA Healthcare (Nashville, TN)
- … coding and documentation improvement education to Providers. + Assists the Director Coding Operations Division Support in reviewing progress against business ... processes, and division relationship management as applicable. The RCOM assists the Regional Coding Operations Director with the oversight and implementation of … more
- HCA Healthcare (Nashville, TN)
- … coding and documentation improvement education to Providers. + Assists the Director Coding Operations Division Support in reviewing progress against business ... processes, and division relationship management as applicable. The RCOM assists the Regional Coding Operations Director with the oversight and implementation of … more
- CVS Health (Nashville, TN)
- …coders within the Special Investigations Unit (SIU) to ensure compliance with coding practices through comprehensive record reviews for medical , behavioral, ... coding and appropriate documentation during the review of medical records. This role requires a strong focus on...contact for the team in the absence of the director , ensuring continuity of operations and support. + Develop… more
- 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 ... orders. + Attends meetings and provides input as it relates to coding , medical documentation, and reimbursement issues specific to medical billing and… more
- Community Health Systems (Franklin, TN)
- …Administration, or a related field preferred + 2-4 years of experience in physician coding , professional fee coding , or medical billing required + Experience ... CPT, HCPCS, and ICD-10 codes for professional fee services documented in the medical record. This role ensures proper sequencing, modifier use, and place-of-service … more
- Evolent (Nashville, TN)
- …The Risk Adjustment Coding Manager plays a crucial role in ensuring accurate medical coding and compliance with risk adjustment models. **What You will Be ... coding questions and issues. + Collaborate with the coding director to develop policies, procedures, and...healthcare administration, or a related field. + **Certification in medical coding (CRC- Certified Risk Adjustment Coder)… more
- Humana (Nashville, TN)
- …mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance, by ensuring compliance with governmental requirements for ... years of healthcare experience in revenue cycle management (related to billing, coding , collections for Medicare and Medicaid claims) + Experience with Auditing and… more
- Humana (Nashville, TN)
- **Become 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 work assignments involve moderately complex to complex issues...conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes,… more
- Sumitomo Pharma (Nashville, TN)
- …seeking a dynamic, highly motivated, and experienced individual for the position of **Associate Medical Director .** The Associate Medical Director will ... for SMPA investigational and commercial products. The incumbent will provide medical safety support for safety signal management throughout product lifecycle… more