Medicare/Medicaid Claims Auditor (Hybrid)
American Health Communities
American Health Plans in Franklin, TN, is seeking a qualified claims auditor to ensure accurate Medicare/Medicaid claims processing and regulatory compliance. The role involves audits, collaboration with processors, and maintaining quality standards within a hybrid work environment in Franklin, TN. Two years of experience with complex claims processing and CMS requirements are preferred. Benefits include health insurance, PTO, and 401(k). #J-18808-Ljbffr
Vacancy posted 4 hours ago
Similar jobs that could be interesting for youBased on the Medicare/Medicaid Claims Auditor (Hybrid) in Franklin, TN vacancy
- ...nursing home operators, these Medicare Advantage plans manage... ...pay audits to ensure accurate claims payments and denials Ensure regulatory... ...claims for Medicare and Medicaid plans Strong knowledge of CMS... ...automated claims processing systems Hybrid role that may require 2-3...ClaimsFull timeTemporary workWork at officeLocal area2 days per week3 days per week
American Health Communities
Franklin, TN4 hours ago - ...Coding And Medical Records Auditor TruHealth is the clinical arm... ...coding audits prior to claims submission. This position will... ...HCC) conditions applicable to Medicare Risk Adjustment reimbursement... ...auditing claims for Medicare and Medicaid plans. ~2 year(s):...Claims
- ...complex caseload from inception through resolution, partnering with claims professionals and insured clients to deliver strategic, cost-... ...outcomes and exceptional legal representation. This is a hybrid position requiring three days per week in a Tennessee office....ClaimsWork at office3 days per week
The Hanover Insurance Group
Franklin, TN2 hours ago - ...information. Key Responsibilities Review, evaluate, appeal, and follow up on outstanding, denied, underpaid, and other assigned claims using EnableComp's proprietary software, systems and tools. Use payment documentation provided by payers and medical provider...ClaimsContract workFlexible hours
- Join The Cigna Group as a Senior Internal Auditor and lead financial and strategic audit and advisory projects that strengthen our controls and support enterprise innovation. In this role, you’ll partner with audit, finance, and accounting stakeholders to identify areas...SuggestedFull timeLocal areaWork from home
- ...Insurance Group in Tennessee seeks a Senior Trial Attorney for a hybrid role, three days per week in a local office. The attorney will... ...exposure civil cases from inception to resolution, coordinating with claims professionals and insured clients to deliver cost-effective,...ClaimsWork at officeLocal area3 days per week
Hanover Insurance Group, Inc.
Brentwood, TN2 hours ago - ...complex caseload from inception through resolution, partnering with claims professionals and insured clients to deliver strategic, cost-... ...outcomes and exceptional legal representation. This is a hybrid position requiring three days per week in a Tennessee office. Candidates...ClaimsFull timeTemporary workWork at officeWork from homeFlexible hoursShift work3 days per week
The Hanover Insurance Group
Franklin, TN2 hours ago - A leading retail organization is seeking an HR Compliance Coordinator for a 3+ month hybrid contract position in Brentwood, TN. The role involves coordinating unemployment claims and background screenings, ensuring compliance with HR policies and state laws. Candidates...ClaimsContract workWork at office
- ...Specialist is responsible for processing and mailing/transmitting claims, tracking claims, monitoring authorization and eligibility of... ...prior to release through PMS Ensure timely filing of all Medicare, Medicaid, and third-party insurance claims Balance daily charges;...ClaimsLocal areaImmediate start
- ...is responsible for completing insurance claims for patient services, follow-up on the claims... ...is made promptly and accurately. Ensure Medicare rejections from IVANS are worked daily... ...Log for Monthly submission: Reviews Medicaid remits daily for Medicare qualifying accounts...ClaimsFull timeTemporary workPart timeRemote work
$98.2k - $163.6k
...help build trend prediction capabilities across clinical and affordability metrics within the CHC Risk Ecosystem. You will connect claims, authorization, service category, diagnosis, and episode-of-care data to help clinical, analytics, finance, and affordability partners...ClaimsFull timeLocal areaWork from home- ...and consultants. Advise and support the divisions of the Companies with general legal support. Assist with liability insurance claims settlement. Examine and interpret documents, actions, statutes, decisions, and ordinances affecting, or potentially affecting,...ClaimsFull timeWork at office
Hirebridge
Franklin, TN1 day ago - ...Health Systems in Franklin, TN is seeking a Manager, Liability Claims to oversee professional and general liability claims, assess liability... ...defense strategies with outside adjusters and attorneys. This HYBRID role requires leadership to ensure compliance with...Claims
Community Health Systems
Franklin, TN5 hours ago $22 - $25 per hour
...| Standard Business Hours Hybrid Optional if Local – Office Located... ...journey, ensuring that every claim is handled with precision,... ...portals (NaviNet, Availity, Medicare portals, and others) and... ...~ Experience working with Medicaid and other commercial insurance...ClaimsFull timeTemporary workLive outWork at officeLocal areaRemote workMonday to FridayFlexible hoursIVX Health
Brentwood, TN5 days ago$600 per month
...Roofing Sales Consultant, you’ll be out in the field connecting with homeowners, performing inspections, and navigating them through the claims process with the support of a powerhouse team behind you. Responsibilities Generate new business through door-to-door canvassing (...ClaimsWeekly payLocal areaQuick Roofing LLC
Franklin, TN22 hours ago- ...designated point of contact for patients regarding billing questions and concerns. The Billing Specialist works on and tracks AR, and claims follow up with third party payors to ensure all transactions are managed properly. This position frequently speaks with payers over...ClaimsWork at office
Mercy Health
Franklin, TN1 day ago - Job SummaryThe Manager, Liability Claims is responsible for overseeing professional and general liability claims, including assessing liability... ...mitigate risk and improve claims management processes.This is a HYBRID position in Franklin, TN.Essential FunctionsManages professional...ClaimsWork at office
- ...legal documentation.Tracks litigation expenses, invoices, settlements, and case status reports.Monitors and reports insurance covered claims and acts as a liaison with malpractice carriersPleadings, Discovery & Court FilingsReviews legal pleadings, motions, subpoenas,...Claims
Summit Behavioral Healthcare
Franklin, TN2 days ago - ...Dentrix for patient scheduling and recordsSchedule and confirm appointments for multiple providers in the officeFile patient insurance claims and follow up on outstanding claims, verification of benefits and explanation of coveragePost insurance and patient payments and...ClaimsWork at officeLocal area
Bartram Family Dental Care
Franklin, TN2 days ago - ...security as it relates to confidential and proprietary information.Key ResponsibilitiesAnalyze and evaluate Veterans Administration (VA) claim payments using EnableComp's proprietary software, systems and tools. Use payment documentation provided by payers to determine if...ClaimsFlexible hours
EnableComp
Franklin, TN4 days ago - ...'s policy benefits and coordination with Medicare Handle complaints (member/provider), via... ...eligibility Performs review of member claim history to ensure accurate tracking of... ...WPM. CSR's should have at least a year of Medicaid/ Medicare experience. CSR must have Call...ClaimsFull timeTemporary workPart timeFor contractorsShift work
Careers Integrated Resources Inc
Franklin, TN3 days ago - ...Dentrix for patient scheduling and records Schedule and confirm appointments for multiple providers in the office File patient insurance claims and follow up on outstanding claims, verification of benefits and explanation of coverage Post insurance and patient payments and...ClaimsDaily paidWork at officeLocal area
Heartland Dental
Franklin, TN2 days ago $124k - $199.8k
...in all aspects of program management such as actuarial pricing, claim or TPA oversight, reinsurance accounting and collateral management... ...candidate’s qualifications***Location:This role will have a Hybrid Work arrangement, with the expectation of working in one of the...ClaimsFull timeTemporary workWork at office3 days per week$133.64k - $152.73k
...their Major Commercial Project team. This position is designated as hybrid (3 days a week in office) and can be located in one of our major... ...of potential risks, compilation of potential change orders and claims, and accurate cost forecasting. Ensure commercial processes and...ClaimsContract workFor contractorsWork at officeFlexible hours3 days per weekSTV
Franklin, TN3 days ago- ...products at a competitive rate to meet the needs of our customers. We provide a knowledgeable Customer Service staff and quick and fair claims service with 24/7 claims reporting. We partner with experienced professional insurance agents that can provide personal service for...ClaimsFull timeTemporary workFlexible hours
Trexis Insurance
Franklin, TN2 days ago - ...'s policy benefits and coordination with Medicare Handle complaints (member/provider), via... ...eligibility Performs review of member claim history to ensure accurate tracking of... ...CSR's should have at least a year of Medicaid/ Medicare experience. CSR must have Call...ClaimsTemporary workShift work
- ...empathetic experts, and outcomes drivers people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you'll play a vital role in helping businesses and individuals move forward with...ClaimsWork at officeLocal area
- ...activities related to the appropriateness of claims adjudication, and for providing support... ...skills Extensive knowledge in Medicare compliance Customer and quality focus... ...requirements Adhere to Centers of Medicare and Medicaid Services (CMS) regulations Successful...ClaimsRemote job
- ...The Claims Specialist administers and evaluates general liability, automobile liability, and third-party property damage claims. This... ...activity and a deadline-driven environment. The role follows a hybrid work model, requiring on-site presence in the office every Tuesday...ClaimsWork at office
CKE Restaurants
Franklin, TN1 day ago $275k - $300k
...team Job Details We are seeking an experienced legal and risk management executive to lead the organization’s litigation, claims, insurance, and enterprise risk functions. This position will oversee a multidisciplinary team responsible primarily for professional...ClaimsLocal areaRelocationRelocation packageJobot
Franklin, TN-114
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Medicare/Medicaid Claims Auditor (Hybrid). Be the first to apply!
Related searches
- remote nurse auditor Franklin, TN
- medical claims auditor Franklin, TN
- claims processing Franklin, TN
- veterans claims Franklin, TN
- healthcare claims Franklin, TN
- medicare analyst Franklin, TN
- medicare sales agent Franklin, TN
- medicare compliance specialist Franklin, TN
- medicare medical director Franklin, TN
- nurse practitioner - medicare assessments Franklin, TN