• Clinical Specialist I, CPT

    Abbott (Memphis, TN)
    …patients throughout the pain continuum. **The Opportunity** As a member of the clinical support team, is responsible for providing technical clinical expertise ... current customers and/or potential customers. Works under general direction with clinical and sales teammates to identify and capitalize on sales opportunities… more
    Abbott (09/17/25)
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  • Referral Specialist II - Paragon Healthcare

    Elevance Health (Nashville, TN)
    …our specialty pharmacies, our infusion centers, and the home setting. **Referral Specialist II - Paragon Healthcare** **Schedule:** Monday - Friday; 9:00am - 6:00pm ... accommodation is granted as required by law._ The **Referral Specialist II** is responsible for providing support to a... II** is responsible for providing support to a clinical team in order to facilitate the administrative components… more
    Elevance Health (10/04/25)
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  • Medication Therapy Management (MTM)…

    Prime Therapeutics (Nashville, TN)
    …every decision we make. **Job Posting Title** Medication Therapy Management (MTM) Specialist - Remote **Job Description** Evaluates and authorizes approval of prior ... from prescribers received by telephone and/or facsimile using client clinical criteria. **Responsibilities** + Determines appropriateness for medications. Communicates… more
    Prime Therapeutics (09/19/25)
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  • SIU Specialist - Pharmacy Tech - Remote…

    Prime Therapeutics (Nashville, TN)
    …our passion and drives every decision we make. **Job Posting Title** SIU Specialist - Pharmacy Tech - Remote in the California market **Job Description** Responsible ... related issue and activities to external departments (Cost Containment, Networks, Clinical ) for handling. + PACKAGING OF FINDINGS AND RECOMMENDATIONS: + Organize… more
    Prime Therapeutics (09/23/25)
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  • Billing and Credentialing Specialist

    WestCare Foundation (Dandridge, TN)
    Billing and Credentialing Specialist Job Details Job Location Dandridge - 207 W Main - Dandridge, TN Position Type Full Time Education Level High School Salary Range ... $60000.00 Salary/year Description Position Summary: The Billing and Credentialing Specialist is responsible for overseeing insurance billing processes, managing… more
    WestCare Foundation (09/04/25)
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  • LTSS Specialist I

    BlueCross BlueShield of Tennessee (Chattanooga, TN)
    **As an LTSS Specialist I you'll be at the heart of a mission\-driven team dedicated to improving the lives of individuals in the CHOICES and ECF CHOICES programs\. ... and helping members navigate their healthcare journey\. You'll collaborate with clinical teams, providers, and families to deliver person\-centered support, while… more
    BlueCross BlueShield of Tennessee (10/03/25)
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  • Profee Coder Urology

    Banner Health (TN)
    …our award-winning patient care. POSITION SUMMARY Evaluates medical records, provides clinical and surgical abstraction and assigns appropriate clinical diagnosis ... edits as appropriate. Reconciliation of charges as required. 2. Abstracts clinical diagnoses, procedure codes and documents other pertinent information obtained from… more
    Banner Health (10/02/25)
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  • Profee Oncology Senior Complex Coder

    Banner Health (TN)
    …physician practices by evaluating medical records and validating that appropriate clinical diagnosis and procedure codes are assigned in accordance with nationally ... edits as appropriate. Reconciliation of charges as required. 2. Abstracts clinical diagnoses, procedure codes and documents other pertinent information obtained from… more
    Banner Health (09/05/25)
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  • Coding Auditor Educator-Inpatient

    Highmark Health (Nashville, TN)
    …staff, physicians and appropriate individuals. (20%) + Validates the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems, missed secondary diagnoses ... appropriate payor specific groups consisting of ICD-CM ICD-PCS and CPT codes for diagnoses and procedures and calculates the...processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and… more
    Highmark Health (09/20/25)
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  • Coding Quality Auditor

    Houston Methodist (TN)
    …utilizing the established physician query process. Provides assistance to Clinical Documentation Management Program (CDMP) with appropriate MS-DRG and APR-DRG ... Case Management and Patient Access Departments in providing appropriate CPT codes for pre-admission and pre-certification requirements including the inpatient… more
    Houston Methodist (09/30/25)
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