- Elevance Health (Nashville, TN)
- ** Clinical Documentation and Claims Integrity Director** **Location:** Alternate locations may be considered. This position will work a hybrid model ... Document Improvement Director** is responsible for leading encounter processing, diagnostic documentation and claims integrity across CareBridge. The ideal… more
- HCA Healthcare (Nashville, TN)
- …payor requirements as it relates to researching, analyzing, and resolving outstanding clinical denials and insurance claims . This job requires regular outreach ... individual is recognized. Submit your application for the opportunity below: Clinical Denials Coding Review SpecialistParallon. **Benefits** Parallon, offers a total… more
- Banner Health (TN)
- …patient care. POSITION SUMMARY This position is responsible for the interpretation of clinical documentation completed by the health care team for the health ... record(s) and for quality assurance in the alignment of clinical documentation and billing codes. Works with...findings. 4. Acts as a knowledge resource to ancillary clinical departments, patient financial services and revenue integrity… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Utilization Management Specialist, Revenue Integrity and Utilization Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health ... management program. The UM Specialist prepares and reviews necessary documentation for insurance utilization management processes and coordinates communication… more
- Healthfirst (TN)
- + Prepare cases for the clinical team by gathering documentation , loading evidence, and making calls to members and providers. + Perform administrative ... + Interacts with other departments including Contact Center Operations, Claims , DSE, and E&B to resolve member and provider...denial files from delegated vendors and prepares cases for Clinical Specialist reviews. + Maintains file integrity … more
- Intermountain Health (Nashville, TN)
- …RCO Appeals Specialist is responsible for researching and appealing denied medical claims . Responsible to proactively identify insurance denial trends and to then ... self-funded, State and Federal insurance) to appropriately appeal medical claims that have been denied. + Conducts and refers...true reason of the denial and review payer contracts, clinical data and other data to be able to… more
- e CancerCare (Nashville, TN)
- …and contacts insurance for reimbursement explanation. Provides clear and accurate documentation of all contacts with internal or external customers. Quickly becomes ... patient care. Consults with appeals department for disputed medical necessity denied claims . Works and Understands electronic claim interchange and the life cycle of… more
- ZOLL Medical Corporation (Knoxville, TN)
- …to promote consistent use (Local Medical Education Programs, Tradeshows, clinical symposiums and conferences). Call points include: Physicians (Cardiologists, ... essential ordering and billing requirements.Essential Functions + Provide customers with relevant clinical data that supports the risk of Sudden Cardiac Death in… more
- Covenant Health Inc. (Knoxville, TN)
- …our values and are intended to increase efficiency and promote data integrity . + Notifies the Financial Counselor immediately upon scheduling or registering any ... based on information given from Medical Records Staff and/or Care Coordinators, ensuring documentation is present in the medical record to support the change. +… more
- Covenant Health Inc. (Crossville, TN)
- …our values and are intended to increase efficiency and promote data integrity . + Notifies the Financial Counselor immediately upon scheduling or registering any ... based on information given from Medical Records Staff and/or Care Coordinators, ensuring documentation is present in the medical record to support the change. +… more