Grievance & Appeals Coordinator I - Nashville

The Senior Ops Coordinator reviews and processes appeals filed by participating providers. · ...

The Senior Ops Coordinator reviews and processes appeals filed by participating providers ensures adherence to regulatory requirements and addresses compliance issues related to Complaint and Appeals policies. · ...

+Job summary · The Grievances and Appeals Coordinator processes medical necessity and administrative denials and appeals for Medicare Advantage members. Processes, tracks and follows up on all medical necessity and administrative denials. · ...

The Division of TennCare is seeking an Appeals Litigation LEGAL ASSISTANT Representative for the Appeals Operations Group within Member Services. · The job involves resolving appeals prior to hearing by identifying prime cases for outreach and conducting outreach to explain the p ...

The Division of TennCare is seeking an Appeals Litigation LEGAL ASSISTANT Representative for the Appeals Operations Group within Member Services. · The representative will work to resolve appeals prior to hearing by identifying · appeals that are prime for outreach, conducting o ...

The Division of TennCare is seeking an Appeals Litigation LEGAL ASSISTANT Representative for the Appeals Operations Group within Member Services. · ...

The Division of TennCare is seeking an Appeals Litigation LEGAL ASSISTANT Representative for the Appeals Operations Group within Member Services.The representative will work to resolve appeals prior to hearing by identifying appeals that are prime for outreach, conducting outreac ...

The Claims Appeals Specialist is responsible for reviewing and processing claims for pre services and post service grievances and appeals requests from customer types (i.e. member, provider, regulatory and third party) related to clinical and non-clinical services, · quality of s ...

The Litigation Assistant will assist in the achievement of a high performing and positive work environment that will promote the TennCare Mission. · Maintain a high-volume caseload and adhere to the timeliness standard of appeals while conducting the due process review. · Daily r ...

The Tennessee Comptroller of the Treasury is seeking a Chief Appraiser to coordinate and perform advanced appraisal work with an emphasis on commercial/industrial real property. · Key responsibilities will include:Collaborate with division leadership to establish strategic goals ...

+ Chief Appraiser position available in Nashville area · +Collaborate with division leadership to establish strategic goals and action items that ensure fair and equitable assessments on a statewide basis through optimized standard operating procedures and sound appraisal practic ...

The Denials Management Specialist position at Houston Methodist leads in reviewing coordinating monitoring clinical denial management appeals process collaborating with Central Business Office management clinical partners to reduce financial risk exposure caused by denials. This ...

The Appeals Litigation LEGAL ASSISTANT Representative will work to resolve appeals prior to hearing by identifying · appeals that are prime for outreach, conducting outreach to explain the position of the state or obtain further information to assist in the processing of appeals. ...

The Division of TennCare seeks an Appeals Litigation LEGAL ASSISTANT Representative to resolve appeals prior to hearing by identifying prime appeals for outreach, · conducting outreach to explain the state's actions related to Medicaid programs, · documenting actions in TEDS when ...

+Job summary · The Collections Coordinator is responsible for performing all collections functions after claims have been submitted and processed. · +ResponsibilitiesExecutes targeted follow-up on outstanding accounts with Medicare, Medicaid, and commercial carriers based on AR a ...

+To provide administrative support to the Vice President of Business & Finance as well as the Office of Business & Finance. · ...

The Division of TennCare is seeking an Appeals Litigation LEGAL ASSISTANT Representative for the Appeals Operations Group within Member Services. The Appeals Litigation LEGAL ASSISTANT Representative will work to resolve appeals prior to hearing by identifying appeals that are pr ...

The Division of TennCare is seeking an Appeals Litigation LEGAL ASSISTANT Representative for the Appeals Operations Group within Member Services.The representative will work to resolve appeals prior to hearing by identifying appeals that are prime for outreach, · conducting outre ...

Bridgehealth Partners is seeking a Family Medicine Physician to join a well-respected and very busy community-based practice in Mt. Juliet, Tennessee, just 20 miles outside of Nashville. Ideal candidates will possess excellent clinical, collaborative and communication skills, be ...

The Tennessee Comptroller of the Treasury is seeking a Chief Appraiser to coordinate and perform advanced appraisal work with an emphasis on commercial/industrial real property. · ...