54 general claims manager jobs found in Nashville

Sumitomo Pharma Co., Ltd., is a global pharmaceutical company based in Japan with operations in the U.S. (Sumitomo Pharma America, Inc.), focused on addressing patient needs in oncology, urology, women's health, rare diseases, cell & gene therapies and CNS. With several marketed products and a diverse pipeline of early- to late-stage investigational assets, we aim to accelerate discovery, research, and development to bring novel therapies to patients sooner. For more information on SMPA, visit our website https://www.us.sumitomo-pharma.com or follow us on LinkedIn. Job Overview We are currently seeking a dynamic, highly motivated, and experienced individual for the position of Sales Account Manager, Oncology. In this field-based role, the Prostate Cancer Sales Specialist will focus on achieving sales goals in their assigned geographic territory. This role serves the Greater Sacramento area and the successful candidate must live within territory. This individual will...

Summary The Security Assistant position is located in the Police Service, VA Tennessee Valley Healthcare System (TVHS). The primary purpose of this position is to dispatch appropriate law enforcement and emergency services to incident and monitor physical security equipment. This job is open to The public U.S. Citizens, Nationals or those who owe allegiance to the U.S. Career transition (CTAP, ICTAP, RPL) Federal employees whose job, agency or department was eliminated and are eligible for priority over other applicants. Clarification from the agency ALL US CITIZENS DIRECT HIRE AUTHORITY: This position is being filled using Direct-Hire Authority (5 CFR 337.205) for this occupation. Duties This position serves as the Security Assistant for Police Service within the Veterans Health Administration (VHA) with a primary purpose to monitor physical security equipment and systems. Major duties and responsibilities include:...

Job Summary The Field Force Effectiveness team at Otsuka America Pharmaceutical, Inc. plays a highly visible role in optimizing the performance of the sales and marketing efforts, for the field sales teams. As a result, Systems Training plays a key role in ensuring that the sales force understands how to effectively utilize our technology to enhance customer interactions, optimize selling opportunities and provide insight on our business processes that support our business. The Senior Manager of National Systems Training work with the field sales teams to design, develop and deliver new hire systems tech training on our InGenius (CRM System), ORION (Field Reporting) and Business Planning system across all brands. The role is also responsible or continual training on system enhancements and capabilities for the organization. In addition, the role will require system training content updates and cross collaboration between systems owners and multiple departments such as...

The Manager, Manufacturing Product Quality (Small molecule) is responsible for ensuring GMP compliance in the manufacturing packaging, labeling, and distribution of commercial and clinical trial materials across global operations. This role supports the oversight of manufacturing and packaging activities performed internally and at external vendors, ensuring that quality standards are met and regulatory requirements are maintained throughout the commercial and clinical supply chains. The manager will collaborate with cross-functional teams including Clinical Operations, Regulatory Affairs, and Supply Chain to ensure the integrity and traceability of investigational products from manufacturing and packaging through delivery. Key Responsibilities Oversee manufacturing of commercial and clinical products at contract manufacturers to ensure compliance with GMP, and applicable global regulatory requirements. Performs batch record review and quality release...

Job Summary The Manager, Clinical Operations works closely with the OPDC Monitoring Oversight Lead to manage monitoring oversight activities including managing Clinical Monitoring Consultants (CMC) contracted to perform monitoring oversight duties as well as escalating issues related to CRO monitoring quality. While focusing on quality and compliance, uses metrics and key performance indicators to drive monitoring oversight activities to achieve timelines and deliverables across the portfolio. Additionally, the Manager, Clinical Operations will support planning, resourcing, contracting, and budgeting of CMC resources to conduct monitoring oversight tasks. The Manager, Clinical Operations will also coordinate reporting and review of CRO related Key Performance Indicators (KPIs) Monitoring Oversight Lead. Job Description Manage Monitoring Oversight activities in North America, and other regions as assigned With the OPDC Monitoring Oversight Lead, plan...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Utilities Service Co Inc. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Description Job Title: Regional Safety Superintendent We are currently seeking a Regional Safety Superintendent to join our team. As a Regional Safety Superintendent, you'll be instrumental in analyzing and enhancing workplace health and safety programs to create a safer, more compliant environment. You'll evaluate existing safety management systems, identifying opportunities for improvement and implementing strategic solutions to mitigate risk. Your expertise...

Our Company Adoration Home Health and Hospice Overview Human Resources works smart to ensure the business has the right talent, focused on the right priorities, at the right time. If you want to make an impact by helping people live their best life, read more below and apply today! Our comprehensive benefits include: Competitive compensation Flexible schedule Employee referral program Tuition reimbursement Paid time off 401(k) retirement savings plan Medical, dental and vision Life insurance Flexible Spending Account (FSA) Employee discounts Community Service Opportunities Responsibilities Provide support, training, and oversight in the areas of employee recruitment, hiring, retention, discipline, evaluation, and employee relations Support operations in recruitment functions to include posting and monitoring job requisitions, screening and presenting potential candidates to...

At Otsuka our mission is to create new products for better health worldwide. Our purpose is to defy limitation so that others can too. In this exciting role, as a Sr. Analyst within OAPI supply chain team, you will work cross-functionally across various departments to support implementation of the S&OP (Sales & Operations Planning) process. You will assist in managing a complex portfolio of products with competing priorities that include balancing inventory, managing vendor / supplier relationships, optimizing total delivered cost to meet finished goods demand with focus on delivering value to our patients, our suppliers, and to Otsuka. You will create an environment for proactive communications with cross functional collaborators that will help ensure both internal and external customer demands are consistently met with no laps in supply and availability of products to our patients. Additional facets of the role include coordinating purchase requisitions in the...

Territory Manager, MEP - Nashville, TN Come build your career. It takes great people to achieve greatness. People with a sense of purpose and integrity. People with a relentless pursuit of excellence. People who care about making things better For Those Who Make The World™. Sound like you? Join our top-notch team of approximately 48,000 diverse and high-performing professionals globally who are making their mark on some of the world’s most beloved brands, including DEWALT®, BLACK+DECKER®, CRAFTSMAN®, STANLEY®, CUB CADET®, and HUSTLER®. The Job: As a Territory Manager, MEP (Mechanical, Electrical, Plumbing) you will be part of the US Commercial Field Sales team working as a remote/field worker. You will manage a territory of various mechanical, electrical, and plumbing (MEP) accounts or a combination of these accounts. You will be responsible for managing your accounts and managing your daily activities including in-person account visits. In this role, you will be...

Territory Manager, MEP - Nashville, TN Come build your career. It takes great people to achieve greatness. People with a sense of purpose and integrity. People with a relentless pursuit of excellence. People who care about making things better For Those Who Make The World™. Sound like you? Join our top-notch team of approximately 48,000 diverse and high-performing professionals globally who are making their mark on some of the world’s most beloved brands, including DEWALT®, BLACK+DECKER®, CRAFTSMAN®, STANLEY®, CUB CADET®, and HUSTLER®. The Job: As a Territory Manager, MEP (Mechanical, Electrical, Plumbing) you will be part of the US Commercial Field Sales team working as a remote/field worker. You will manage a territory of various mechanical, electrical, and plumbing (MEP) accounts or a combination of these accounts. You will be responsible for managing your accounts and managing your daily activities including in-person account visits. In this role, you will be...

Summary This position is located in the Nursing Perioperative Wound Care unit at the Nashville VA Medical Center. This job is open to The public U.S. Citizens, Nationals or those who owe allegiance to the U.S. Internal to an agency Current federal employees of the hiring agency that posted the job announcement. Clarification from the agency NOTE: The 2-page Resume requirement does not apply to this position. For more information, refer to Required Documents below Duties The Registered Nurse (Wound Care, Ostomy and Continence Specialist) utilizes the nursing process to manage conditions such as acute wounds, chronic wounds, fistulas, vascular ulcers, pressure ulcers, arterial ulcers, venous ulcers, neuropathic ulcers and functional disorders of the bowel and bladder for Acute Care, Long Term Care, Ambulatory Care, and Rehabilitation. The RN reports to the Clinical Nurse Manager and the Chief Nurse, Perioperative, Nursing...

Nashville (Charlotte), TN 5708 Charlotte Pike, Nashville, TN 37209-3215, United States of America Pay : $12.00 - $12.50 It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. We are looking for a Member Services Representative to join our team! This position will be responsible for creating a positive member experience by providing a superior level of customer service to Planet Fitness members, prospective members and guests. Essential Duties and Responsibilities Greet members, prospective members and guests, providing exceptional customer service. Handle all front desk related activities including: Answer phones in a friendly manner and assist callers with a variety of questions. Check members into the system. Take prospective members on tours. Sign up new members calculating rates and monthly payment amounts. Assist the Club Manager in counting...

Equal access to programs, services and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the Human Resources Department by email at HRAdmin@glowbrands.com. Earn up to $20.00/hr!* Base Pay - $15.00/hr or more + performance and store bonuses =average $20.00/hr * While $20.00 an hour is not guaranteed, it reflects the average earnings of management who meet all performance and training criteria. We reward strong performance, reliability, and leadership with ongoing and monthly bonus opportunities! We're looking for motivated leaders to join our management team at Sun Tan City. If you have retail management experience, strong customer service skills, and a passion for team leadership, this is your opportunity to grow your career. Top Benefits and Perks Health Insurance options (Medical, Dental, Vision) Life Insurance & Disability...

Equal access to programs, services and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the Human Resources Department by email at HRAdmin@glowbrands.com. Earn up to $20.00/hr!* Base Pay - $15.00/hr or more + performance and store bonuses =average $20.00/hr * While $20.00 an hour is not guaranteed, it reflects the average earnings of management who meet all performance and training criteria. We reward strong performance, reliability, and leadership with ongoing and monthly bonus opportunities! We're looking for motivated leaders to join our management team at Sun Tan City. If you have retail management experience, strong customer service skills, and a passion for team leadership, this is your opportunity to grow your career. Top Benefits and Perks Health Insurance options (Medical, Dental, Vision) Life Insurance & Disability...

Nashville (South Nashville), TN 1021 Murfreesboro Pike, Nashville, TN 37217, United States of America Pay : $12.00 - $12.50 It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. We are looking for a Member Services Representative to join our team! This position will be responsible for creating a positive member experience by providing a superior level of customer service to Planet Fitness members, prospective members and guests. Essential Duties and Responsibilities Greet members, prospective members and guests, providing exceptional customer service. Handle all front desk related activities including: Answer phones in a friendly manner and assist callers with a variety of questions. Check members into the system. Take prospective members on tours. Sign up new members calculating rates and monthly payment amounts. Assist the Club Manager in...

ACCOUNTS RECEIVEABLE REP III REMOTE Company Overview: AMSURG is an independent leader in ambulatory surgery center services, operating a network of more than 250 surgery centers nationwide. In partnership with physicians and health systems, the organization delivers high-quality care for patients across a diverse spectrum of medical specialties, including gastroenterology, ophthalmology and orthopedics. To learn more about AMSURG, visit www.amsurg.com. Position Summary The Representative Accounts Receivable III is responsible for follow up on intermediate outstanding accounts receivable. Work Schedule: Remote Essential Responsibilities Follow-up on outstanding claims and appeals Work escalation views Review Vendor Clarification logs Provide employee and vendor training Acts as a knowledge resource for team members Not limited to working Claim Ack Rejections, Claim Edits & Charge Corrections Phone patients for payment or payment arrangements Print...

ACCOUNTS RECEIVEABLE REP III REMOTE Company Overview: AMSURG is an independent leader in ambulatory surgery center services, operating a network of more than 250 surgery centers nationwide. In partnership with physicians and health systems, the organization delivers high-quality care for patients across a diverse spectrum of medical specialties, including gastroenterology, ophthalmology and orthopedics. To learn more about AMSURG, visit www.amsurg.com. POSITION SUMMARY: The Representative Accounts Receivable III is responsible for follow up on intermediate outstanding accounts receivable. Work Schedule: Remote ESSENTIAL RESPONSIBILITIES: Follow-up on outstanding claims and appeals Work escalation views Review Vendor Clarification logs Provide employee and vendor training Acts as a knowledge resource for team members Not limited to working Claim Ack Rejections, Claim Edits & Charge Corrections Phone patients for payment or payment...

Company Description At Western Digital, our vision is to power global innovation and push the boundaries of technology to make what you thought was once impossible, possible. At our core, Western Digital is a company of problem solvers. People achieve extraordinary things given the right technology. For decades, we've been doing just that. Our technology helped people put a man on the moon. We are a key partner to some of the largest and highest growth organizations in the world. From energizing the most competitive gaming platforms, to enabling systems to make cities safer and cars smarter and more connected, to powering the data centers behind many of the world's biggest companies and public cloud, Western Digital is fueling a brighter, smarter future. Binge-watch any shows, use social media or shop online lately? You'll find Western Digital supporting the storage infrastructure behind many of these platforms. And, that flash memory card that captures and preserves...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Performance Suite Analytics team offers candidates the opportunity to generate meaningful impact through translating disparate data points into tangible insights and actions....

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Eligibility Analyst- REMOTE Job Description The Eligibility Analyst is responsible for representing commercial or government programs' eligibility and acts as a subject matter expert for department projects, Run functions and escalated client issues. This role is responsible for mentoring and training the Eligibility Specialist. Responsibilities Serves as subject matter expert representing eligibility on file process for new and existing clients and department projects; monitors eligibility mailbox and Prime Resolution daily, participates in workstream meetings, assists with providing information regarding business requirements, and performs User Acceptance Testing Serves as primary contact for external...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Performance Suite Analytics team offers candidates the opportunity to generate meaningful impact through translating disparate data points into tangible insights and actions....

Become a part of our caring community and help us put health first The Grievances & Appeals Representative 2 manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal or further request is warranted and then delivers final determination based on trained skillsets and/or partnerships with clinical and other Humana parties. The Grievances & Appeals Representative 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. The Grievances & Appeals Representative 2 assists members, via phone or face to face, further/support quality related goals. Investigates and resolves member and practitioner issues. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Performance Suite Analytics team offers candidates the opportunity to generate meaningful impact through translating disparate data points into tangible insights and actions....

Manager Process Improvement - Payment Integrity Location : It is highly preferred that the selected candidate resides in one of the following cities/states: Chicago, IL; Miami, FL; Tampa, FL; Atlanta, GA; Indianapolis, IN; Nashville, TN; Grand Prairie, TX. Hybrid 2 : This role requires associates to be in-office *3 * days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. 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. The Manager Process Improvement is responsible for...