Supervisor, Clinical Document Integrity (CDI) Covenant HealthSupervisor, Clinical Document Integrity (CDI)Knoxville, TNUnder the direction of the CDI Manager, directs the day-to-day activities in the centralized medical coding operation to service the various business entities of Covenant Health, which includes the planning and maintenance of daily activities and special projects as necessary to achieve and maintain business objectives. With more than 300 physicians and advanced practice providers in 20 communities, our team delivers expertise across a broad spectrum of specialties from primary care and walk-in clinics to preventive medicine and advanced surgical and subspecialty services.
NewClinical Quality Improvement Coordinator - Eye Exam Specialist GuidehealthClinical Quality Improvement Coordinator - Eye Exam SpecialistNashville, TNRemote$60,000–$64,000 / yearSuccess in this role requires comfort operating specialized retinal imaging equipment (full training and camera provided), strong attention to detail, willingness to travel daily to provider practices and patient homes for scheduled eye exam appointments, knowledge of healthcare quality measures, comfort working with health data and multiple systems, strong communication skills, and the ability to manage deadlines in a field/remote hybrid environment. On days without scheduled eye exam appointments, this role supports the broader quality improvement initiatives across delegated entities and contracted Accountable Care Organizations (ACOs), including quality reporting, performance improvement, patient outreach, quality gap closure, and data abstraction activities across Medicare Advantage STAR, Commercial, Medicaid, and MSSP ACO quality programs.
Supervisor, Revenue Cycle Clinical Coder Denials | Enterprise Denials | Remote (FL, GA, MO, PA, NC, SC, TN, TX) University of Florida Health Science CenterSupervisor, Revenue Cycle Clinical Coder Denials | Enterprise Denials | Remote (FL, GA, MO, PA, NC, SC, TN, TX)TNRemoteDemonstrated knowledge of hospital billing, reimbursement, denials and appeals, third-party payer contracts, insurance protocols, and revenue cycle workflows. Trains staff on revenue integrity policies, analyzes financial data for strategic insights, and implements improvements to optimize revenue capture.
Clinical Documentation Integrity (CDI) Medical Records Technician HYRE HARPER Co.Clinical Documentation Integrity (CDI) Medical Records TechnicianMemphis, TennesseeAs a Medical Records Technician (MRT) specializing in Clinical Documentation Integrity, you will collaborate with healthcare providers, coding professionals, and clinical staff to ensure that medical records accurately reflect the patient’s clinical status, diagnoses, and treatment plans. Certifications: Must hold current certification from one or more of the following: ACDIS (Association of Clinical Documentation Integrity Specialists): Certified Clinical Documentation Specialist (CCDS)).
NewRevenue Cycle Manager - Full Time - Germantown, TN West Cancer CenterRevenue Cycle Manager - Full Time - Germantown, TNGermantown, TNWorking under the general direction of the Director of Revenue Cycle, this role oversees billing operations, supervises revenue cycle staff, and supports process improvements to enhance efficiency and financial performance. Plan, organize, and manage billing activities and revenue cycle staff across insurance credentialing/set-up, coding, data entry, collections, insurance verification, patient billing, correspondence, compliance, refunding/credit balances, and accounts receivable follow-up.
NewPatient Services Representative, Ambulatory Internal Resource Pool, FT, Days Prisma HealthPatient Services Representative, Ambulatory Internal Resource Pool, FT, DaysMaryville, TNResponsible for complete and accurate patient registration, precertification, charge capture and accurately coding diagnoses given by physicians. Enters all charge and same day payment information for patient visits and hospital patients, verifying accuracy of coding, charging and patient insurance status.
PreVisit Planning Coder - Summit Medical Group Summit Medical GroupPreVisit Planning Coder - Summit Medical GroupKnoxville, TNWith use of specified reports, HCC database, Athena EHR, hospital portals, member summaries and Group Management, review all records, progress notes and diagnosis for accuracy and completeness of documentation to support ICD coding to the highest level of specificity. Continuous use and awareness of ethical coding, the official coding rules, regulations, and coding conventions of the American Hospital Association (Coding Clinic), ICD-9/ICD-10-CM, Centers for Medicare, and Medicaid Services (CMS), and organizational/institutional coding guidelines.
Previsit Planning Coder - Summit Medical Group Summit Medical GroupPrevisit Planning Coder - Summit Medical GroupKnoxville, TNWith use of specified reports, HCC database, Athena EHR, hospital portals, member summaries and Group Management, review all records, progress notes and diagnosis for accuracy and completeness of documentation to support ICD coding to the highest level of specificity. Continuous use and awareness of ethical coding, the official coding rules, regulations, and coding conventions of the American Hospital Association (Coding Clinic), ICD-9/ICD-10-CM, Centers for Medicare, and Medicaid Services (CMS), and organizational/institutional coding guidelines.
NewHIM/MEDICAL RECORDS COORDINATOR University Health Services IncHIM/MEDICAL RECORDS COORDINATORFranklin, TNMake a meaningful impact on patient care and healthcare operations Gain hands-on experience with medical coding, electronic medical records, and healthcare information systems Expand your knowledge of HIPAA regulations and health information management best practices Work alongside experienced healthcare professionals in a collaborative environment Opportunities for professional development and career growth Be part of an organization committed to service excellence, teamwork, and patient confidentiality What You'll Do As the HIM Coordinator, you will support the day-to-day operations of the Health Information Management Department by: Assigning accurate ICD-10-CM diagnostic and procedure codes for inpatient and outpatient records Reviewing and maintaining patient health information for accuracy and completeness Ensuring strict compliance with HIPAA regulations and federal guidelines related to the release of protected health information Protecting the confidentiality and integrity of patient medical records in all formats, including electronic, written, verbal, and dictated information Abstracting patient data into electronic systems for reporting, analysis, and claims processing Conducting coding audits, medical record audits, quality audits, and statistical data reviews Assisting with record maintenance, filing, storage, retrieval, and document management processes Supporting department initiatives and additional HIM-related responsibilities as assigned Qualifications Required Qualifications High school diploma or GED 1-3 years of Health Information Management, medical records, coding, or related healthcare experience Knowledge of ICD-10-CM coding principles Strong computer skills and experience working with electronic medical records Excellent organizational, customer service, and communication skills Ability to maintain confidentiality and handle sensitive information with professionalism and integrity Preferred Qualifications Registered Health Information Technician (RHIT) Certified Coding Specialist (CCS) Experience with:3M Encoder/Coding software Electronic Medical Record (EMR) systems Release of Information processes Medical record auditing and compliance Why Rolling Hills Hospital? At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries.
CENTRAL APPEALS SUPPORT SPECIALIST University Health Services IncCENTRAL APPEALS SUPPORT SPECIALISTBRENTWOOD, TNRemotePOSITION SUMMARY: Central Appeals Support Specialist This role is responsible for managing and supporting the behavioral health appeals process, including following up with insurance companies, refiling denied or underpaid claims, and maintaining detailed records of appeal outcomes. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.
Director of Revenue Operations - Nashville (Hybrid) ForMotionDirector of Revenue Operations - Nashville (Hybrid)Nashville, TennesseeOur clinic is part of the ForMotion global network of Patient Care clinics owned by Embla Medical , which also owns Össur , a leading global provider of prosthetics and bracing and supports solutions; Fior & Gentz, an innovative developer of neuro orthotics; and College Park, creators of custom-built prosthetic solutions for people of all activity levels. ForMotion is a global network of Orthotic & Prosthetic patient care clinics providing exceptional care through award-winning mobility solutions and world-class healthcare professionals.
Medical Technical Assistant 1- OB/GYN (Knoxville) University of Tennessee SystemMedical Technical Assistant 1- OB/GYN (Knoxville)Knoxville, TNJOB SUMMARY/ESSENTIAL JOB FUNCTIONS: The Medical Technical Assistant 1 provides nursing support to Internal Medicine residents and attending physicians. LICENSE/CERTIFICATION:Current licensure as Certified Medical Assistant (CMA), or CCMA in the state of Tennessee required.
Supervisor, Utilization Management TriWest Healthcare AllianceSupervisor, Utilization ManagementNashville, TNRemoteFull timeTechnical Skills: Thorough knowledge of policies and procedures, knowledge of managed care principles and methods; medical terminology; proficiency in the application of clinical criteria: InterQual, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, current Procedural Terminology, and Healthcare Common Procedural Coding System, and American Dental codes; working knowledge with medical management systems; proficient with Microsoft Office; knowledge of UM Process; reporting techniques. • Prepares work schedules and monitors staff caseloads to ensure adequate staffing levels at all times and accurate data entry and application of the medical management system.
Intake Specialist II Full-time - Murfreesboro, TN TwelveStone Health PartnersIntake Specialist II Full-time - Murfreesboro, TNMurfreesboro, TNChronic conditions include Multiple Sclerosis, NMOSD, Myasthenia Gravis, CIDP, ITP, Migraine Prevention, Crohn's Disease, Ulcerative Colitis, Plaque Psoriasis, Alpha 1 Antitrypsin Deficiency, Primary Immunodeficiency, hATTR Amyloidosis, Thyroid Eye Disease, and many others. Verify insurance coverage to determine patient OOP, obtain documentation to ensure the product(s) are being ordered meet(s) insurance requirements, coordinate with authorization counterparts to ensure all information required by insurance is successfully authorized, dispense and bill medication.
Intake Specialist II Full-Time - Murfreesboro, TN TwelveStone Health PartnersIntake Specialist II Full-Time - Murfreesboro, TNMurfreesboro, TNChronic conditions include Multiple Sclerosis, NMOSD, Myasthenia Gravis, CIDP, ITP, Migraine Prevention, Crohn's Disease, Ulcerative Colitis, Plaque Psoriasis, Alpha 1 Antitrypsin Deficiency, Primary Immunodeficiency, hATTR Amyloidosis, Thyroid Eye Disease, and many others. Verify insurance coverage to determine patient OOP, obtain documentation to ensure the product(s) are being ordered meet(s) insurance requirements, coordinate with authorization counterparts to ensure all information required by insurance is successfully authorized, dispense and bill medication.
Intake Specialist II TwelveStone Health PartnersIntake Specialist IIMurfreesboro, TNChronic conditions include Multiple Sclerosis, NMOSD, Myasthenia Gravis, CIDP, ITP, Migraine Prevention, Crohn's Disease, Ulcerative Colitis, Plaque Psoriasis, Alpha 1 Antitrypsin Deficiency, Primary Immunodeficiency, hATTR Amyloidosis, Thyroid Eye Disease, and many others. Verify insurance coverage to determine patient OOP, obtain documentation to ensure the product(s) are being ordered meet(s) insurance requirements, coordinate with authorization counterparts to ensure all information required by insurance is successfully authorized, dispense and bill medication.
NewDirector of Physician Practice Revenue Cycle AscensionDirector of Physician Practice Revenue CycleNashville, Tennessee$138,258.29–$195,187.61 / yearFull timeWhat minimum qualifications you'll need: Education: High School diploma equivalency with 5 years of applicable cumulative job specific experience required, with 2 of those years being in leadership/management OR Associate's degree/Bachelor's degree with 3 years of applicable cumulative job specific experience required, with 2 of those years being in leadership/management. Provide strategic direction across the revenue cycle continuum (i.e. patient registration, coding, billing, denials management, and collections) with accountability for medical group KPI performance including net collection rate, days in A/R, denial rates, etc.
Medical Coder 2 Baptist Memorial Health Care CorpMedical Coder 2Memphis, TNDescription: Minimum Required: Skill and proficiency in coding inpatient and outpatient (ancillary, emergency department, outpatient surgery, etc.) records utilizing ICD-9-CM and CPT-4 through 3 years'' experience in an acute care facility. Serves as a resource to physicians, physician office staff, clinical documentation specialists, case managers, etc.
COMPLIANCE AUDITOR SR Covenant HealthCOMPLIANCE AUDITOR SRKnoxville, TennesseeFull timeAdvises, educates and acts as clinical/billing liaison between system-wide facility leaders, department managers and billing staff as designated by manager in relation to audit findings and process improvement initiatives. Covenant Health is the region’s top-performing healthcare network with 10 hospitals , outpatient and specialty services , and Covenant Medical Group , our area’s fastest-growing physician practice division.
Compliance Auditor SR Covenant HealthCompliance Auditor SRKnoxville, TNCovenant Health Overview: Covenant Health is the region's top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area's fastest-growing physician practice division. Advises, educates and acts as clinical/billing liaison between system-wide facility leaders, department managers and billing staff as designated by manager in relation to audit findings and process improvement initiatives.
Referral Specialist Skilled Nursing Facility - NHC Centralized Referral Operation (CRO) National HealthCare CorpReferral Specialist Skilled Nursing Facility - NHC Centralized Referral Operation (CRO)Pulaski, TNAs a Referral Specialist Skilled Nursing Facility, your duties will include managing multiple referral platforms, summarize patient referrals using medical terminology, collaborating between accepting SNF and referral source, and ensuring internal and external customers' needs are met. We would like for you to consider our opportunity to join the Centralized Referral Operation and carry out our vision of seamless transfers of patients from the acute care setting to post-acute care, one patient at a time.
Field Reimbursement Manager - Tennessee Ocular TherapeutixField Reimbursement Manager - TennesseeNashville, Tennessee$200,000–$220,000 / yearCustomers will include Healthcare Providers (HCPs) and staff within offices, ambulatory surgery centers (ASCs), hospital outpatient departments (HOPDs), and other appropriate site-of-care facilities. Ocular Therapeutix, Inc. (NASDAQ:OCUL) is a biopharmaceutical company focused on the formulation, development, and commercialization of innovative therapies for diseases and conditions of the eye using its proprietary bioresorbable hydrogel-based formulation technology, ELUTYX.
Director of Risk Management and Revenue Integrity American Health PlansDirector of Risk Management and Revenue IntegrityFranklin, TNFull timeThis role acts as the risk adjustment program subject matter expert and works closely with other areas of health plan operations and programs, ensuring risk adjustment data operations are administered accurately, timely and in compliance with CMS regulations. • Enjoy engaging in the outlining of program development and management processes, manages the overall scoping, planning, business requirements gathering and delivery of risk adjustment program activities from idea inception to ongoing support and enhancement.
NewRadiology Technologist/Ma - Lookout Mtn Practice - M-F Erlanger HealthRadiology Technologist/Ma - Lookout Mtn Practice - M-FChattanooga, TNPrimary duties include but are not limited to escorting patients to exam rooms, taking vital signs, preparation for evaluations and/or procedures as directed by physician or PA/NP, collections of laboratory tests, processing of waived or non-waived laboratory tests, performing X-Ray. Is trained and assigned (as per their role and responsibilities) to coordinate care for patients and is trained and assigned to support patients/families/caregivers in self-management, self-efficacy and behavior change.
Physician Office Billing Coordinator Ascension HealthPhysician Office Billing CoordinatorNashville, TNRemote$19.73–$26.70 / hourOur legitimate email communications will always come from an @ascension.org email address; do not trust other domains, and an official offer will only be extended to candidates who have completed a job application through our authorized applicant tracking system. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you’ll find an inclusive and supportive environment where your contributions truly matter.
NewMedical Coder 3 Baptist Memorial Health Care CorpMedical Coder 3Memphis, TNOne of the following: Certified Coding Specialist (CSS), Certified Coding Specialist Physician (CCSP), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Outpatient Coder (COC/CPCH), Certified Professional Coder Payer (CPCP). Skill and proficiency in coding physician/professional and outpatient (ancillary, emergency department, oupatient surgery, etc. ) records utilizing ICD-9-CM and CPT -4 through 5 years experience in an acute care facility, professional office or intergrated health system.
Field Reimbursement Manager - Tennessee Ocular Therapeutix IncField Reimbursement Manager - TennesseeNashville, TN$200,000–$220,000 / yearCustomers will include Healthcare Providers (HCPs) and staff within offices, ambulatory surgery centers (ASCs), hospital outpatient departments (HOPDs), and other appropriate site-of-care facilities. Ocular Therapeutix, Inc. (NASDAQ:OCUL) is a biopharmaceutical company focused on the formulation, development, and commercialization of innovative therapies for diseases and conditions of the eye using its proprietary bioresorbable hydrogel-based formulation technology, ELUTYX.
Director of Physician Practice Revenue Cycle Ascension Health AllianceDirector of Physician Practice Revenue CycleNashville, TNRemote$138,258.29–$195,187.61 / yearEducation: High School diploma equivalency with 5 years of applicable cumulative job specific experience required, with 2 of those years being in leadership/management OR Associate''s degree/Bachelor''s degree with 3 years of applicable cumulative job specific experience required, with 2 of those years being in leadership/management. Provide strategic direction across the revenue cycle continuum (i.e. patient registration, coding, billing, denials management, and collections) with accountability for medical group KPI performance including net collection rate, days in A/R, denial rates, etc.
Senior Revenue Financial Analyst and Team Lead (A/R) Aegis Sciences CorpSenior Revenue Financial Analyst and Team Lead (A/R)NASHVILLE, TNThe Senior Revenue Financial Analyst and Team Lead (A/R) is responsible for analyzing and optimizing a healthcare organization's revenue cycle processes by reviewing financial data, identifying areas for improvement, and developing strategies to maximize revenue while ensuring compliance with regulations, often collaborating with various departments within the revenue cycle team to implement changes and monitor their effectiveness. Responsible for maintaining both contractual and bad debt rates for assigned payers including, but not limited to, forecasting changes in payer rates, expected vs actual variance review, identification of variance, communication, and resolution of variances.
Nurse Practitioner - PPV CompassusNurse Practitioner - PPVMemphis, TNThe Nurse Practitioner, if providing hospice care, functions as an extension of the interdisciplinary team (IDT) and hospice physician to provide routine recertification and emergency assessments, educational, and evaluative services to meet the needs of patients and their families. If providing Hospice Face to Face Visits: Performs routine and emergency assessments: Completes routine and emergency recertification visits on each patient entering their 3rd benefit period or beyond (including admissions and transfers).
Director, RCM Analytics & Insights OneOncologyDirector, RCM Analytics & InsightsNashville, TennesseeThis leader will work daily with the VP-Analytics and Data Products and the overall analytics team, the Chief Revenue Officer, RCM leadership and Finance leadership to use data on enterprise-level RCM performance trends and root-cause assessments to identify operational improvement opportunities related to registration accuracy, billing accuracy, payer denials, underpayments, and revenue leakage, while driving sustainable improvements in cash flow, reimbursement accuracy, and operational efficiency. The Director, RCM Analytics and Insights , is a newly created position responsible for leading the development, communication and insights surrounding advanced RCM KPIs, analytics and other metrics identifying actionable opportunities to optimize all aspects of RCM performance.
Director, RCM Analytics & Insights oneOncologyDirector, RCM Analytics & InsightsNashville, TNThis leader will work daily with the VP-Analytics and Data Products and the overall analytics team, the Chief Revenue Officer, RCM leadership and Finance leadership to use data on enterprise-level RCM performance trends and root-cause assessments to identify operational improvement opportunities related to registration accuracy, billing accuracy, payer denials, underpayments, and revenue leakage, while driving sustainable improvements in cash flow, reimbursement accuracy, and operational efficiency. Job Description: The Director, RCM Analytics and Insights, is a newly created position responsible for leading the development, communication and insights surrounding advanced RCM KPIs, analytics and other metrics identifying actionable opportunities to optimize all aspects of RCM performance.
Software Engineer (Salesforce) (US REMOTE) Motorola Solutions IncSoftware Engineer (Salesforce) (US REMOTE)TNRemote$100,000–$110,000 / yearRequired Skills & Qualifications: Salesforce Certifications (preferred): Salesforce Certified Application Architect, Salesforce Certified Advanced Developer, Salesforce Revenue Cloud Consultant, Salesforce CPQ Specialist, or equivalent. Integration & Maintenance: Design and develop integrations between Salesforce and other enterprise systems (ERP, marketing automation, etc.) using tools like MuleSoft, REST/SOAP APIs, and middleware platforms.
NewSenior Systems Analyst Methodist Le Bonheur HealthcareSenior Systems AnalystMemphis, TNWorking at MLH means carrying the mission forward of caring for our community and impacting the lives of patients in every way through compassion, a deliberate focus on service expectations and a consistent thriving for excellence. Ability to work varying hours due to the accessibility of individuals or equipment involved in different projects, the need to minimize system downtime or user interruption, or to recover from hardware or software failures.
VP, RCM Business Operations OneOncologyVP, RCM Business OperationsNashville, Tennessee$180,000–$230,000 / yearThis individual will be responsible for helping coordinate the day-to-day execution of all RCM functions, working with the Chief Revenue Officer (“CRO”) and the other RCM Vice Presidents to optimize performance, ensure proactive communication with practices, manage risks and issues along with the overall OO RCM team. OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases.
VP, RCM Business Operations oneOncologyVP, RCM Business OperationsNashville, TN$180,000–$230,000 / yearJob Description: This individual will be responsible for helping coordinate the day-to-day execution of all RCM functions, working with the Chief Revenue Officer ("CRO") and the other RCM Vice Presidents to optimize performance, ensure proactive communication with practices, manage risks and issues along with the overall OO RCM team. OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases.
Field Reimbursement Manager Mallinckrodt LLCField Reimbursement ManagerMemphis, TN$102,000–$150,000 / yearContinually educate office staff on appropriate steps, educate on the importance of chart documentation, keep offices up to date on payer policies for KEENOVA products and triage issues to the appropriate HUB and Specialty Pharmacy. Systemic understanding of the global payer and distribution environment, in particular, biologic In-Office Injectables (IOI) in the U.S. Understanding of coverage, coding (diagnostic, procedural and product), payment and reimbursement requirements and policies.
Practice Manager II, Pediatric Pulmonology Erlanger HealthPractice Manager II, Pediatric PulmonologyChattanooga, TNJob Summary: The Practice Manager Operations II reports to a Director of Practice Operations and is responsible for the day-to-day operations of one or more medical practices, with a total of five or more physicians generating in excess of 2.5 million in total charges per year. Department Position Summary: The Practice Manager Operations II is responsible for daily operations of one or more physician practices to include registration, cash collection, charge preparation, medical record documentation, referral/authorizations, related insurance and coding process.
Medical Insurance Collector Surgery Partners IncMedical Insurance CollectorMemphis, TNAll claims are coded with CPT and ICD-10 codes according to the findings in the medical record so the candidate must have a strong working knowledge of coding/billing processes and reading and understanding an explanation of benefits (EOB). This person is responsible for managing and recovering outstanding payments from insurance companies, Researching denied claims, sending appeals and reconsiderations.
NewProfessional Documentation Improvement Auditor ardent healthProfessional Documentation Improvement AuditorBrentwood, TNArdent includes:30 hospitals280 sites of care4,281 beds24,000+ team members8,200+ nurses1,800+ aligned providers5.8M annual provider encounters421 medical residentsArdent makes considerable investments in people, technology, facilities, and communities, producing high quality care and extraordinary results. CCC – Certified Cardiology Coder, COBGC – Certified OB/GYN Coder), strongly preferredE&M /Procedure/Surgery Auditing/Critical Care/Specialty Specific/Skewed Productivity CurvesApplication and validation of ICD-10 diagnosis codes based on coding guidelinesPreferred Job Requirements:Revenue Cycle experience Additional specialty specific certifications (e.g.
Director, RCM Analytics & Insights OneOncology IncDirector, RCM Analytics & InsightsNashville, TNThis leader will work daily with the VP-Analytics and Data Products and the overall analytics team, the Chief Revenue Officer, RCM leadership and Finance leadership to use data on enterprise-level RCM performance trends and root-cause assessments to identify operational improvement opportunities related to registration accuracy, billing accuracy, payer denials, underpayments, and revenue leakage, while driving sustainable improvements in cash flow, reimbursement accuracy, and operational efficiency. Job Description: The Director, RCM Analytics and Insights, is a newly created position responsible for leading the development, communication and insights surrounding advanced RCM KPIs, analytics and other metrics identifying actionable opportunities to optimize all aspects of RCM performance.
Program Integrity Investigator (Healthcare Fraud Waste & Abuse) TriWest Healthcare AllianceProgram Integrity Investigator (Healthcare Fraud Waste & Abuse)Nashville, TNRemoteFull timeComplies with the Veterans Affairs Community Care Network (CCN) and TRICARE T-5 contracts; DHA and TRICARE program guidelines and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, Military members and family (as warranted), providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals. The PI Investigator t is responsible for the identification, analysis, case development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA), the Healthcare Finance Administration (HCFA) and the Department of Defense, Defense Health Agency for the TRICARE program; requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).
VP, RCM Business Operations OneOncology IncVP, RCM Business OperationsNashville, TNJob Description: This individual will be responsible for helping coordinate the day-to-day execution of all RCM functions, working with the Chief Revenue Officer ("CRO") and the other RCM Vice Presidents to optimize performance, ensure proactive communication with practices, manage risks and issues along with the overall OO RCM team. OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases.
Medical Coder 6 Baptist Memorial Health Care CorpMedical Coder 6Memphis, TNSkill and proficiency in coding inpatient records utilizing ICD CM and CPT through a minimum of 2 years'' experience in an acute care facility, 4 years preferred. Codes diagnoses and procedures of inpatient records and abstracting information at defined facilities for reimbursement, research, and to generate statistical data.
NewInpatient Audit Specialist FT- Sign on Bonus DatavantInpatient Audit Specialist FT- Sign on BonusNashville, TNRemote$35–$45 / hourAs an Inpatient Auditing Specialist you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, andlife sciences companies.
Patient Accounting - Accounts Receivable - Full Time Murfreesboro Medical Clinic PAPatient Accounting - Accounts Receivable - Full TimeMurfreesboro, TNYou'll play an important role in providing excellent care, supporting patients through meaningful moments, and working alongside a supportive team. The Insurance Follow-Up Specialist plays a critical role in ensuring timely and accurate reimbursement for healthcare services provided by the office.
Field Reimbursement Manager Immunology Gastroenterology - Nashville TN AbbVie IncField Reimbursement Manager Immunology Gastroenterology - Nashville TNNashville, TNThe amount and availability of any bonus, commission,incentive, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Companys sole and absolute discretion unless anduntil paid and may be modified at the Company's sole and absolute discretion, consistent with applicable law. Applicable only to applicants applying to a position in any location with pay disclosure requirements under state or local law: The compensation range described below is the range of possible base pay compensation that the Company believes in good faith it will pay for this role at the time of thisposting based on the job grade for this position.
Manager, Account Follow-Up Services Harris Computer SystemsManager, Account Follow-Up ServicesTN$70,000–$90,000 / yearSkills: • Revenue Cycle Management (RCM) Expertise: Good understanding of all RCM steps: front-end, coding, billing, accounts receivable (AR), denial management, and collections. Serving over 1,000 healthcare facilities nationwide, MEDHOST offers a comprehensive suite of products, including electronic health records (EHR), financial management systems, and patient engagement platforms.
(Remote) Manager, Account Follow-Up Services Harris Computer Systems(Remote) Manager, Account Follow-Up ServicesBrentwood, TNRemoteAs a wholly owned subsidiary of Constellation Software Inc. ("CSI", symbol CSU on the TSX), Harris has become the cornerstone for CSI's investment in utility, local government, school districts, public safety, and healthcare software verticals. Serving over 1,000 healthcare facilities nationwide, MEDHOST offers a comprehensive suite of products, including electronic health records (EHR), financial management systems, and patient engagement platforms.
NewMedical Billing Specialist American Health Companies IncMedical Billing SpecialistFranklin, TNJOB SUMMARY: The Medical Billing Specialist for Nurse Practitioners is responsible for processing and mailing/transmitting claims, tracking claims, monitoring authorization and eligibility of payor benefits, managing the collections process and posting cash receipts. Receive and review Daily Reconciliation Review (DAR) document for accuracy; enter charges into Practice Management System (PMS).