28 jobs found in Nashville

Be Part of an Extraordinary Team Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. Build the Possibilities. Make an Extraordinary Impact. Title : DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) Virtual:? ? This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidates...

Job Type Full-time Description ***Work at Home*** Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Tennessee. TOA concentrates on the diagnosis and treatment of disorders and injuries of the musculoskeletal system which allow our patients to live their best life. Ninety plus years later we are advancing the practice of orthopaedic surgery throughout the state. There are a number of reasons why TOA is an employer of choice; here are a few of them: Stability - TOA has been in Middle Tennessee since 1926 and has expanded to over 20+ locations across the state! Impact - TOA's team members use our careers - whether in our clinics or our business office to make a positive difference in the community by building relationships and helping patients live their best life. Work Environment - The TOA team focuses on fostering an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement. Total Rewards...

Datavant is the data collaboration platform trusted for healthcare. 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, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing...

Become a part of our caring community and help us put health first The Medical Coder extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The Medical Coder confirms appropriate diagnosis related group (DRG) assignments. Review and analyze patient medical records to identify accurate ICD-10-CM diagnosis codes, ensuring all relevant conditions affecting patient's care are documented to the highest level of specificity. Validate that documentation supports risk adjustment coding and HCC capture in compliance with regulatory guidelines. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions are regarding the daily...

Outpatient Coder Opportunity Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate...

Inpatient Medical Coding Auditor Become a part of our caring community and help us put health first. The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing...

Inpatient Hospital Medical Coder An inpatient hospital medical coder is a healthcare professional responsible for reviewing and analyzing patient medical records from hospital stays and assigning standardized codes for diagnoses and procedures. These codes are primarily based on ICD-10-CM (International Classification of Diseases) and PCS (Procedure Coding System) standards. Responsibilities: Review clinical documentation to assign accurate ICD-10-CM and ICD-10-PCS codes. Communicate with physicians to clarify diagnoses and procedures through the query process. Utilize electronic encoder applications to assign codes in compliance with practice policies and regulatory guidelines. Maintain a minimum accuracy rate of 98% while meeting internal productivity standards. Achieve productivity expectations: Inpatient 1624 encounters per day or 23 encounters per hour. Complete reports and perform additional duties as requested by management from the hospital side of forms (not...

Pharmacist Supervisor for Vanderbilt Medical Group Clinic Pharmacy Discover Vanderbilt University Medical Center: Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniqueness is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research. Organization: VMG/Infusion/Outpatient Clinical Manager Job Summary: Supervises the pharmacy team for a...

Coding Account Resolution Specialist-Outpatient Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. We are seeking a Coding Account Resolution Specialist-Outpatient for our team to ensure that we continue to provide all patients with high quality, efficient care. Did you get into our industry for these reasons? We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply! The Coding Account Resolution Specialist-II (CARS-II) works outpatient coding related alerts/edits for SDC, OBV, and Wound Care, accounts, predominately post initial/final coding. The CARS-II performs the alert/edit resolution activities in the applicable systems. The...

Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we've been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! This open position is within one of our subsidiary companies called CGS Administrators. CGS has been a proven provider of administrative and business services for state Medicaid agencies, managed care organizations, commercial health plans, Medicaid members, Medicare...

A pharmaceutical services company based in Nashville, TN, is seeking an individual responsible for conducting inventory audits at client sites. Key responsibilities include managing documentation, communicating effectively with clients, and ensuring timely assignment completions. A High School Diploma or GED is required; a college degree is preferred. Transportation to various audit sites is necessary, and prior experience in the pharmaceutical industry is advantageous. #J-18808-Ljbffr

Inpatient Coder Opportunity Do you have the career opportunities as an Inpatient Coder you want with your current employer? We have an exciting opportunity for you to join Parallon, which is part of the nation's leading provider of healthcare services, HCA Healthcare. Our teams are a committed, caring group of colleagues. Do you want to work as a(an) Inpatient Coder where your passion for creating positive patient interactions is valued? If you are dedicated to caring for the well-being of others, this could be your next opportunity. We want your knowledge and expertise! Job Summary and Qualifications As a work from home Inpatient Coding Specialist, you will review and evaluate hospital inpatient medical record documentation to assign, sequence, edit, and/or validate the appropriate ICD-10-CM and ICD-10-PCS codes. You will perform coding and/or code/DRG validation across multiple entities. What you will do in this role: Assigns, sequences, validates, and/or edits codes/DRGs...

Medical Biller Position We are seeking a skilled and detail-oriented Medical Biller to join our team. In this role, you will be responsible for managing the billing process, ensuring accurate claim submissions, and following up on payments and reimbursements. This remote position is ideal for candidates with experience in medical billing and coding who want to work in a flexible, virtual environment. Key Responsibilities Prepare, review, and submit accurate medical claims to insurance companies or government programs. Verify patient insurance coverage and eligibility for services. Process claims for reimbursement and ensure timely follow-up on denied or unpaid claims. Post payments, adjustments, and reconcile billing statements. Communicate with insurance companies to resolve claim discrepancies, rejections, or denials. Assist patients with billing inquiries and resolve payment issues. Ensure compliance with healthcare regulations and billing standards (e.g., HIPAA,...

Medical Coder Become a part of our caring community and help us put health first. The Medical Coder extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The Medical Coder confirms appropriate diagnosis related group (DRG) assignments. Review and analyze patient medical records to identify accurate ICD-10-CM diagnosis codes, ensuring all relevant conditions affecting patient's care are documented to the highest level of specificity. Validate that documentation supports risk adjustment coding and HCC capture in compliance with regulatory guidelines. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions are regarding the...

Regional Medical Associate Director-Central Join the team transforming care for people with immune challenges, rare diseases, cancers, and neurological conditions. In Specialty Care, you'll help deliver breakthrough treatments that bring hope to patients with some of the highest unmet needs. The US Rare Disease, Regional Medical Associate Director (RMAD)-Central, will be responsible for cross-portfolio support including proactive engagement of select HCPs across multiple specialties. The RMAD will support pipeline initiatives, with a focus on enhancing awareness of disease states associated with late-stage pipeline assets (including alpha-1 antitrypsin deficiency-AATD) among HCPs across a breadth of accounts. We're an R&D-driven, AI-powered biopharma company committed to improving people's lives and delivering compelling growth. Our deep understanding of the immune system and innovative pipeline enables us to invent medicines and vaccines that treat and protect millions of...

Coding Specialist III Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE). JOB SUMMARY: The Coding Specialist III will review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the needs of hospital data retrieval for billing and reimbursement. Coding Specialist III validate MSDRG and/or APC calculations in order to accurately capture the diagnoses/procedures documented in the clinical record. Coding Specialist III performs documentation review and assessment for accurate abstracting of clinical data to meet regulatory and...

Coding Resolution Specialist- Outpatient Coder Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Submit your application for the opportunity below: Coding Resolution Specialist- Outpatient Coder Parallon. This is a work from home position. Fully flexible schedule Monday-Friday! Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and disability coverage, flexible...

Senior Inpatient HIM Coder We are seeking a highly skilled and experienced Senior Inpatient HIM Coder to join our dynamic healthcare information management team. This role is crucial in bridging the gap between clinical data and technology, as we aim to develop cutting-edge AI solutions for medical coding and billing processes. The successful candidate will play a pivotal role in providing valuable insights and expertise to enhance our product development efforts. Requirements and Qualifications: A minimum of 3 years of hands-on experience as an acute HIM inpatient medical coder in a hospital environment. Proficiency in identifying and extracting ICD-10-CM, ICD-10-PCS, HCPCS/CPT codes, and associated modifiers from patient records. In-depth understanding of supporting evidence requirements for accurate coding. Practical experience using grouper software for MS-DRG and APR-DRG assignment. Strong communication skills to interact effectively with the billing department...

Job Type Full-time Description At Athena Care, our mission is to improve access to quality mental health care so that people can live happier, healthier, more productive lives. Our vision is to create the leading mental health services platform in Tennessee and neighboring states. Services include diagnostic assessment, medical management, psychotherapy, and TMS and Spravato treatments along with Intensive Outpatient Services for adolescents and adults. Founded in 2001, Athena Care is "in-network" with most major insurance plans. Athena Care is currently seeking a Supervisor of Medical Support Services for our Nashville and surrounding clinics with a schedule of Monday - Friday, 8am - 5pm. The Supervisor, Medical Support Services, provides leadership, oversight, and operational supervision for Athena Care's medical support teams, with primary responsibility for Medical Technicians (in-clinic) and Medical Technician Phone Line / Float staff workflows. This role ensures...

Vanderbilt University Medical Center Compliance Operations Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniqueness is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research. Organization: Compliance Operations - VUH Job Summary: Applies specialized skills and training independently to evaluate and advise whether professional,...

Job Description Job Description Why Charlie Health? Millions of people across the country are navigating mental health conditions, substance use disorders, and eating disorders, but too often, they're met with barriers to care. From limited local options and long wait times to treatment that lacks personalization, behavioral healthcare can leave people feeling unseen and unsupported. Charlie Health exists to change that. Our mission is to connect the world to life-saving behavioral health treatment. We deliver personalized, virtual care rooted in connection—between clients and clinicians, care teams, loved ones, and the communities that support them. By focusing on people with complex needs, we're expanding access to meaningful care and driving better outcomes from the comfort of home. As a rapidly growing organization, we're reaching more communities every day and building a team that's redefining what behavioral health treatment can look like. If you're ready to use your...

Become a part of our caring community and help us put health first Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures,...

Job Description Job Description About the company Steadfast Health was founded to establish a new standard of substance use disorder (SUD) care. Recognizing that traditional treatment methods often fall short of reaching patients when they're most in need, Steadfast is relentlessly focused on making low-barrier, high quality care accessible to all. We know that the journey to recovery is unique for every individual, and our patient-centered approach ensures we meet patients where they are, providing evidence-based therapies with unwavering support in a compassionate environment that fosters healing and growth. We are growing rapidly and building a dedicated team of professionals who are committed to fulfilling our mission – join us! Position Summary We are seeking our first in-seat Certified Medical Coder to help build and lead our Behavioral Health and Substance Use Disorder (SUD) coding function. The ideal candidate will bring 3–5+ years of hands-on experience coding...

A prestigious pharmaceutical company is seeking an Associate Director of Global Medical Affairs Strategy & Operations. This pivotal role is essential for driving operational excellence within the Global Medical Affairs organization. We are looking for a dynamic leader who will collaborate with cross-functional teams to: Develop and execute innovative strategic plans. Manage budgets effectively. Enhance process improvements to streamline operations. If you possess a minimum of 7 years of relevant experience in Global Medical Affairs, along with robust project management and leadership skills, we strongly encourage you to apply. Join us in making a significant impact in the pharmaceutical industry, while enjoying a competitive benefits package! Location: Nashville, TN