• UR Clinical Specialist

    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
    Community Health Systems (07/29/25)
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  • Delaware Valley ACO Fellowship

    Humana (Nashville, TN)
    …data reporting, performance improvement, physician engagement, informatics, network development, and contract/ payer relations . This design gives the Fellow the ... opportunity to build fundamental communication, analytic, and problem-solving skills as well as an understanding of the ACO environment and population health strategies. To complement on-the-job training, fellows are involved in Board and other administrative… more
    Humana (07/30/25)
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  • Dir Patient Accounting

    Covenant Health Inc. (Knoxville, TN)
    …cashiering, etc.) + Responsible for Patient Accounting system master file integrity, payer monitoring, and customer relations . + Remain current on procedural ... and problems that arise routinely within responsibility area. Examples Include: payer delays; patient complaints; serious computer problems; legal Issues; regulatory… more
    Covenant Health Inc. (07/18/25)
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  • EVG Patient Account Rep - Medical Biller

    Covenant Health Inc. (Knoxville, TN)
    …This position demonstrates the ability to accurately submit claims in all payer categories, ie, Medicare, TennCare, Blue Cross, Commercial, and Managed Care. This ... timely manner. Analyzes claim edits within billing system and payer sites with a variety of different issues, such...duties as assigned or requested. + Promotes good public relations for the department ad the facilities, adhering to… more
    Covenant Health Inc. (06/06/25)
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  • Field Reimbursement Manager Tzield - Central

    Sanofi Group (Nashville, TN)
    …billing and coding, financial assistance offerings, patient support, access, payer medical policy, prior authorization, specialty pharmacy operations, infusion ... be subject matter experts on product procurement as it relates to medical payer policy requirements, buy & bill processes, billing and coding education, claims and… more
    Sanofi Group (08/17/25)
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  • PT Acct Billing Liaison

    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
    Covenant Health Inc. (08/15/25)
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  • Patient Account Rep I Corporate

    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. (07/22/25)
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  • Patient Account Rep II Corporate

    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. (08/11/25)
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  • Patient Account Rep II Corporate

    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. (07/24/25)
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  • Facility Coding Inpatient DRG Quality

    Banner Health (TN)
    …Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations , you'll find many options for contributing to our award-winning patient ... its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group (APR-DRG) and Ambulatory Payment Classification (APC) or utilized… more
    Banner Health (08/30/25)
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