64 jobs found in tennessee

Job Summary: Responsible for creating a comprehensive estimate of damages for 1st and 3rd party material damage claims leading to the proper disposition. This role is utilized as a peer mentor having mastered our processes and obtained technical expertise. Key Responsibilities: Exhibits mastery estimating fundamentals in order to create estimates of damages on 1st and 3rd party material damage losses of all severities Applies mastered content in interpretations of all policy types written by the company and assists leadership in formal and ad hoc training Negotiates settlements, makes settlement payments and documents all activities in the most complex of files Interprets regulatory compliance and fair claims practices Builds mastered relationships with both internal and external customers Supervisory Responsibilities: This job does not have supervisory duties Preferred Qualifications: Education and Experience Bachelor's degree preferred or equivalent...

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Provides utilization management review of worker's compensation claims . Accesses medical documentation and information provided by medical providers to determine the appropriateness of treatment, setting and length of treatment required. Essential Duties & Responsibilities: Communicates with medical providers and ancillary service providers to negotiate or approve treatment. Engages physician review agents as appropriate. Communicates and documents recommendations of treatment to all parties including claims professionals, medical providers, ancillary service providers,...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)   No industry is moving faster than health care. And no organization is better positioned to lead health care forward. We need attention to every detail with an eye for the points no one has considered. The rewards for performance are significant. You'll help improve the health of millions. We are looking for an experienced Senior Consultant as an addition to the Optum Payment Integrity Practice in Optum Payer Consulting. Responsibilities require solid understanding healthcare claims data, basic PPS concepts, UB04 and HCFA 1500 claim...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm) As an Analytic Development Consultant, you will be responsible for supporting the identification, development, and presentation of new medical cost savings opportunities on behalf of our clients. This position will support assessment of new opportunities based on data insights leveraging tools, policies, industry trends, and by soliciting input from a broad network of experts across Optum. This position requires a strong analytical skillset, data analysis and healthcare claims experience (HCFA/UB) to detect incorrectly paid claims for...

This is a remote Field Claims Adjuster position. The ideal candidate will be located in the Memphis, TN area. Job Summary: This role utilizes analytical skills to create a comprehensive estimate of damages for 1st and 3rd party material damage claims leading to the proper disposition. Key Responsibilities: Exhibits proficient estimating fundamentals in order to create estimates of damages on 1st and 3rd party material damage losses Processes a deep understanding of the content of all policy types written by the company Negotiates settlements, makes settlement payments and documents all activities in the file within escalated authority limits Applies thorough understanding of regulatory compliance and fair claims practices Builds established relationships with both internal and external customers Supervisory Responsibilities: This job does not have supervisory duties Preferred Qualifications: Education and Experience Bachelor's degree preferred or...

Job Summary: This role will provide complex and technical support and training for licensing/registration, appointing, contracting, terminating and servicing agents according to the regulations of 50 states, foreign jurisdictions and multiple company policies. Key Responsibilities: Work with multiple business partners to obtain applicable information needed for class records and reports Organize, prepare, and facilitate completion of licensing forms for new hire classes Review documents needed for candidate test registration and licensing Work with vendors and business units to schedule dates for property and casualty exam Maintain and manage exam results and schedule subsequent attempts when needed Manage/maintain existing records through license renewal applications and continuing education requirements Analyze, review and process documents to renew licenses and appointments according to specifications Performs highly complex processes that requires clear...

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Key Responsibilities: Provides medical management to workers compensation injured employees. Performs case management through telephonic contact with all medical providers, employers, claims professionals and ancillary service providers. Manage medical care in order to return injured employee to preinjury status. Reviews services of medical and rehabilitation providers and arranges for and coordinates appropriate evaluation, treatment, and counseling. Communicates with physician, injured worker, employer, referral source, and any other resource involved in worker's rehabilitation program....

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Provides utilization management review of worker's compensation claims . Accesses medical documentation and information provided by medical providers to determine the appropriateness of treatment, setting and length of treatment required. Essential Duties & Responsibilities: Communicates with medical providers and ancillary service providers to negotiate or approve treatment. Engages physician review agents as appropriate. Communicates and documents recommendations of treatment to all parties including claims professionals, medical providers, ancillary service providers,...

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Utilization Review and Compliance Manager Responsible for the state and URAC reporting for GBCARE TCM, FCM, and UR. Will establish additional state filings to increase revenue across TCM, FCM, and UR. Key Responsibilities: Manages proper distribution of workload across UR team. Utilizes individual metrics and team performance, identify development opportunities and provide direction for team improvement. Leads all programming changes associated with Review Stat system. Manages all LOA customization for clients, which includes client reporting associated with the LOA program....

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Under moderate management, supervises a team of claims adjusters. Actively drives adjuster hiring and leads adjuster training. Actively manages assigned adjuster workloads and performance. Participates in compliance and best practice reporting. Demonstrates a thorough understanding of corporate policies and procedures. Essential Duties & Responsibilities: Uses various metric driven tools such as FOCUS, the Claim Operation Tool Kit to evaluate performance and identify problem areas in advance of them becoming service issues. Reviews findings with manager to jointly develop a plan for...

This is a remote Field Claims Adjuster position. The ideal candidate will be located in the Memphis, TN area. Job Summary: This role utilizes analytical skills to create a comprehensive estimate of damages for 1st and 3rd party material damage claims leading to the proper disposition. Key Responsibilities: Exhibits proficient estimating fundamentals in order to create estimates of damages on 1st and 3rd party material damage losses Processes a deep understanding of the content of all policy types written by the company Negotiates settlements, makes settlement payments and documents all activities in the file within escalated authority limits Applies thorough understanding of regulatory compliance and fair claims practices Builds established relationships with both internal and external customers Supervisory Responsibilities: This job does not have supervisory duties Preferred Qualifications: Education and Experience Bachelor's degree preferred or...

What can go right when you can grow your career? Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, we have over 150 years of experience, serve more than 25 industries, and insure 90% of the Fortune 500®. Zurich strives to provide ongoing career development opportunities so you can reach your full potential and foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. With the support of people like you, we are optimistic about leading the next evolution of the insurance industry. Join us in building a brighter future for our people, our customers and the communities we serve.   Zurich is currently looking for a Staff Legal Counsel III.   This position may work out of one of the following North American...

Req ID: 183935 NTT DATA Services strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a Sr. Digital Sales Executive to join our team in Nashville, Tennessee (US-TN), United States (US). Digital Sales Executive IV - Nashville At NTT DATA we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company's growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA Services and for the people who work here. NTT Data is searching for an experienced, growth-minded Sr. Digital Sales Executive capable of interfacing with the C-suite, based in Nashville, TN . In this role, you will serve as a trusted partner to our customers by...

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Provides utilization management review of worker's compensation claims . Accesses medical documentation and information provided by medical providers to determine the appropriateness of treatment, setting and length of treatment required. Essential Duties & Responsibilities: Communicates with medical providers and ancillary service providers to negotiate or approve treatment. Engages physician review agents as appropriate. Communicates and documents recommendations of treatment to all parties including claims professionals, medical providers, ancillary service providers,...

What can go right when you can grow your career? Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, we have over 150 years of experience, serve more than 25 industries, and insure 90% of the Fortune 500®. Zurich strives to provide ongoing career development opportunities so you can reach your full potential and foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. With the support of people like you, we are optimistic about leading the next evolution of the insurance industry. Join us in building a brighter future for our people, our customers and the communities we serve.   Zurich is currently looking for a Staff Legal Counsel III.   This position may work out of one of the following North American...

Gainwell Technologies LLC Summary As a Mailroom Associate - Nashville, TN at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position. Your role in our mission Sorting, delivering mail and shipping outgoing mail and packages Identifies, prioritizes and resolves some issues independently, and escalates more complex questions or issues appropriately.  Coding/indexing healthcare documents: claims, enrollment forms, correspondence Preparing and scanning related documents Ability to operate small courier van. What we're looking for Typically, 1-2 years of working experience in related fields. Must possess a Valid Driver’s License Clean Driving...

Surest™, a UnitedHealthcare Company, (formerly Bind) provides a new approach to health benefits designed to make it easier and more affordable for people to access health care services. Our innovative company is part tech start-up, part ground-breaking service delivery-changing the way benefits serve customers and consumers to deliver meaningful results and better outcomes (and we have just begun). We understand our members and employers alike desire a user-friendly, intuitive experience that puts people in control when it comes to the choices they make and the costs they pay for medical care. At Surest, we pride ourselves in our ability to make a difference, and with the backing of our parent company, UnitedHealthcare, we can operate in the best of both worlds—the culture and pace of an innovative start-up with big company support and stability. Come join the Surest team and help us design and deliver a cutting-edge health benefit that changes the face of health care. Sr....

Gainwell Technologies LLC Summary We are looking for someone who can assist with leading projects being developed using the IBM DataStage tool. Someone that can mentor and train new DataStage developers. This person must be team oriented and self-motivated as well be able to take direction from more experienced team members, project team and client. Performs assigned ETL activities and performs analysis on data to ensure accuracy of code and results generated. Determines best practices and provides suggestions on how to improve the current coding or data extraction.  The candidate is expected to be able to develop program code based on technical specifications.    Your role in our mission •    Creates and execute accurate ETL process. •    Uses existing experience in healthcare to drive processes •    Supports the ETL team with projects and activities •    Presents analysis and design recommendations to project leads or customer into the acceptance of the design. •...

Gainwell Technologies LLC Summary As a Power BI Dashboard Developer   at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position. Your role in our mission This position calls for a professional who is a problem-solver, who takes ownership of tasks and drives them to completion, an Azure BI Developer with experience working with the entire Microsoft SQL BI Stack, from ingest to Dashboard, as well as their related Azure cloud components.  This includes participating in customer meetings to gain a complete understanding of the business problem and related requirements. It also involves analyzing, profiling, and mapping data elements to model and create...

Healthcare Risk Consultant   The Healthcare Risk Consultant applies his or her risk management expertise to promote and improve clients’ safety culture through on-site safety inspections, written healthcare safety programs and healthcare safety training presentations. He or she works directly with clients to assess and mitigate their safety risks and exposure through preventative, pro-active policies and procedures. The Healthcare Risk Consultant focuses on both workers’ compensation and professional liability. Your goals. Your ambitions. Your definition of success. At MMA, we believe nothing should stand in your way of making these a reality. As an MMA colleague, you’ll get personal and professional development opportunities, a driven and entrepreneurial team-oriented environment, and leaders at all levels who are committed to maintaining high levels of colleague engagement. As a part of Marsh McLennan (NYSE: MMC), the world’s leading professional services firm in risk,...