Coding Denials Auditor
Enablecomp · Franklin, TN
Job description(tap to read)
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers (ASCs) nationwide. Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert human-in-the-loop integration, EnableComp provides solutions across the revenue lifecycle for Veterans Administration, Workers' Compensation, Motor Vehicle Accidents, and Out-of-State Medicaid claims as well as denials for all payer classes. By partnering with clients to supercharge the reimbursement process, EnableComp removes the burden of payment from patients and provider organizations while enabling accelerated cash, higher and more accurate yield, clean AR management, reduced denials, and data-rich performance management. EnableComp is a multi-year recipient the Top Workplaces award and was recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024 and is among the top one percent of companies to make the Inc. 5000 list of the fastest-growing private companies in the United States for the last eleven years. Position Summary The Coding Denials Auditor provides analysis of coded medical services, reports, records, and billed charges, etc. to determine appropriateness of the medical coding utilized, delivery of care and treatment plans. The Coding Denials Auditor will use their expertise and coding expertise to communicate internally and externally. Key Responsibilities • Conducts coding audits of submitted claims to determine appropriateness of procedure and diagnosis codes billed based on documentation provided for both outpatient facility and professional claims. • Reviews Billing for accuracy to ensure compliance of proper billing and coding procedures of third-party carriers and to ensure complete and accurate reimbursement. • Coordinates with revenue cycle teams to investigate rejected or denied claims to determine denial accuracy and work in an inter-departmental collaboration process to assist in claim corrections/appeals • Effectively utilizes computer and appropriate software (Microsoft Office Suite) to produce correspondence, charts, spreadsheets and/or other information applicable to the position assignment, including a basic to intermediate level of competency in Excel which is required • Maintains knowledge regarding medical coding and/or healthcare market changes. • Gather and analyze claims and medical records information pertinent to documentation findings and outcomes; use this information to make educated decisions. • Draft appeals to payors using nationally sourced coding guidelines such as CPT Assistant, specialty societies, state fee schedule language, AAPC/AHIMA articles etc. • Other duties as required. Requirements and Qualifications • Associates or Bachelor's Degree • Current certification in one of the following: Certified Professional Coder (CPC) or related certification by AAPC, Certified Coding Associate (CCA) by AHIMA, Certified Coding Specialist (CCS) by AHIMA, Registered Health Information Technician (RHIT) by AHIMA. • The applicant must have a strong background in orthopedics and surgery billing/coding. The ideal candidate has 5+ years of experience in orthopedic surgery billing, a solid background in coding and medical billing, with special emphasis on AR, EOB's, and overall account management, including coding denials. • Must be able to gather and analyze claims and medical records information pertinent to documentation findings and outcomes; use this information to make educated decisions. • Must have strong written communication skills. This position requires the ability to draft grammatically correct well written appeals to payors using nationally sourced coding guidelines such as CPT Assistant, specialty societies, state fee schedule language, AAPC/AHIMA articles etc. • Sound time management skills with the ability to manage workload independently • Strong analytical, problem solving and research skills with the ability to utilize creative thinking • Must be comfortable with CAC/Encoder audits and be able to identify appropriate code selection from audit findings. • Equivalent combination of education and experience will be considered. • Ability and skill set to work remotely. • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions • Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook). • Regular and predictable attendance. Special Considerations and Prerequisites • Familiarity with healthcare documentation systems. • Experience with multiple fee schedule concepts such as DRGs, APCs, and NCCI. • Strong verbal, written and interpersonal communication and customer service skills. • Ability to communicate audit outcomes and testing results with other staff within the company who are both medically and non-medically oriented. • Ability to interpret policies and procedures and communicate complex topics to others. • Ability to think critically and make decisions within individual role and responsibility. • Complex Claims medical billing and coding experience strongly preferred. EnableComp is an Equal Opportunity Employer M/F/D/V. All applicants will be considered for this position based upon experience and knowledge, without regard to race, color, religion, national origin, sexual orientation, ancestry, marital, disabled or veteran status. We are committed to creating and maintaining a workforce environment that is free from any form of discrimination or harassment. EnableComp recruits, develops and retains the industry's top talent. As the employer of choice in the complex claims industry, EnableComp takes pride in our continuous commitment to building and maintaining a culture centered around fostering the professional growth and development of our people. We believe that investing in our employees is the key to our success, and we are dedicated to providing them with the tools, resources, and support they need to thrive and grow their career here. At EnableComp, we are committed to living up to our core values each and every day, and we believe that this commitment is what sets us apart from other companies. If you are looking for a company that values its employees and is dedicated to helping them achieve their full potential, then EnableComp is the place for you. Don't just take our word for it! Hear what our people are saying: "I love my job because everyone shares the same vision and is determined and dedicated. People care about you as a person and your professional growth. There is a genuine spirit of cooperation and shared goals all revolving around helping each other." - Revenue Specialist "I enjoy working for EnableComp because of the Core Values we believe in. EnableComp stands true to these values from empowering employees to ecstatic clients. This company is family oriented and flexible, along with understanding the balance of work, life, and fun." - Supervisor, Operations
Service Truck Mechanic
Nashville Ready Mix · Franklin, TN
Service Truck Mechanic needed for Nashville Ready Mix. Candidates must have experience working on Cat, Cummins and Detroit. Must also have electronic knowledge along with troubleshooting abilities. We offer good competitive pay and benefits. Immediate positions available to start right away. Benefits include competitive hourly pay, paid health/vision/ dental insurance after 90 days, paid vacation time after 6 months, holiday pay after 90 days, company uniforms and more. Our operations throughout Middle Tennessee supply quality ready mix concrete to the construction industry. Nashville Ready Mix operates 13 fully automated plants and a fleet of over 150+ front discharge ready mix trucks. Our products are manufactured and distributed using only the highest industry standards, quality, service and integrity. Nashville Ready Mix will continue to be a dedicated leader using the latest equipment, technology, research and development available within the industry. Integrity, superior quality and exceptional service will always be the foundation of our future. recblid wp03tw6i5x0pttggn8whpfzsaj93l6
Jared Jewelry Specialist
Jared Jewelers · Franklin, TN
Job Description: We have many opportunities available on our other career site pages. Click here to link to our careers page! At Jared, we know that jewelry is more than a ring or pendant no matter how sparkling and brilliant. Which is why we empower every one of our jewelry consultants with the innovation, training and resources to help our customers Celebrate Life and Express Love in new and engaging ways. Jared is part of Signet Jewelers, a purpose-driven company who believes love inspires love. Signet is also "Great Place to Work-Certified" . There are brilliant career paths awaiting you - rewarding opportunities to impact the lives of others and inspire love. Join us! Jared Jewelers is now hiring! Do you thrive on building personal relationships that will last a lifetime? Join our team today to help our customers celebrate life and express love! Your role at Jared Jewelers: As a part of our Sales Team you are responsible for providing a superior experience to our valued customers. In addition, you will: • Engage customers in conversation to understand their needs and desires • Ability to present merchandise and share detailed information regarding features and benefits of products • Provide information regarding extended service plans and financing options • Meet individual and team sales goals We think you'd be great for this role if you have: • A desire to help our customers celebrate the special moments in their lives • Strong customer service, sales, retail and/or jewelry experience • Flexible availability to work during "peak" retail hours such as nights, weekends, and holidays • A positive, customer -focused approach in delivering an exceptional customer experience • Strong communication and relational skills We put our People First by offering the following benefits: • Base pay plus commission on sales • Medical, dental, vision and prescription insurance (full-time team members) • 401(k) • Paid Time Off (full-time and part-time team members) • Paid holidays (full-time team members) • Tuition reimbursement, including DCA courses based on position • Training - Associate Training System, Management Training System, District Manager in Training, career development and more • Merchandise discounts • Incentive trips and contests Jared Jewelers is part of the Signet Jewelers family and is an equal opportunity employer committed to promoting inclusion and diversity for all employees. We value integrity, teamwork and offer opportunities for advancement as part of our promote from within philosophy. Please know that while we appreciate every applicant's interest in joining our team, we can only contact those selected for further consideration. Don't forget, we have many opportunities available on our other career site pages. Click here to link to our careers page!
Senior Estimator
Civil Constructors, LLC · Franklin, TN
Civil Constructors is looking for a Senior Estimator to join our team. Essential Duties and Responsibilities • Analyze construction drawings and project specifications to prepare accurate cost estimates. • Interpret and understand contract terms and conditions. • Develop detailed, well-organized estimates and proposals under deadline. • Provide comprehensive quantity take-offs for grading, drainage, utilities, and asphalt paving. • Solicit and evaluate subcontractor and material supplier quotes, ensuring full coverage of project scopes. • Maintain strong relationships with subcontractors and clients; provide clarification and explore value engineering options. • Collaborate closely with field personnel to ensure smooth project transitions • Support Project Managers in the transfer of Field Management • Assist the Chief Estimator in mentoring and training junior staff Qualifications and Experience • Minimum of 5+ years of experience with heavy civil and highway construction projects. • Strong written and verbal communication skills. • Degree in Civil Engineering, Construction Management program is preferred. • Experience working in the construction field in a similar or related field, or equivalent experience. • Proficiency in: Microsoft Excel, AGTEK 4D, On-Screen Take-Off, Building Connected experience with HCSS's HeavyBid. • A driven professional ready to take ownership of estimating responsibilities. • Comfortable working in a fast-paced environment with multiple deadlines. • A team player with long-term leadership potential, the ideal candidate will aspire to move into executive management. Effective leadership and management skills with the ability to motivate, direct, and evaluate a team. • Must pass all company and other required drug and alcohol tests. • Must be authorized to work in the United States. • Must be able to speak, read, and write fluently in English.
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Restaurant Staff - $10.50-$17.50/hr - Spring Hill - Urgently Hiring (37064)
Taco Bell · Franklin, TN
Taco Bell - Port Royal is looking for a full time or part time Restaurant Staff team member to join our team in Spring Hill, TN. The Restaurant Staff team member is responsible for customer service and commitment to excellence through meeting or exceeding hospitality and service standards.Restaurant Staff responsibilities include:-Effectively communicate with management in a timely manner regarding scheduling issues, customer service problems, and equipment malfunctions.-Follow all safety procedures and guidelines including personal safety, equipment use, and food handling and storage.-Ensure all products are stocked, maintained, and prepared according to company quality standards.-Maintain a clean, safe working environment.-Clean the customer service areas by following the proper procedures as directed by the manager on duty, including outside landscaping, building entrances, dining room tables and condiment stations, restrooms, and food production and storage units.-Demonstrate fiscal responsibility with all company assets by following company cash handling policies.-Demonstrate ability to be a "team player" by contributing to the team's success and communicating effectively with other Customer Service Representatives.-Assume additional responsibilities as assigned.-Maintain or exceed standards of appearance, cleanliness, hygiene, and health standards.-Frequent washing of hands.A qualified candidate will have:-A high school diploma or equivalent or higher preferred but not required-Strong work ethic and willingness to learn-Demonstrated ability to work in a team environment.We look forward to seeing you for an interview for our full time or part time Restaurant Staff role at Taco Bell - Port Royal soon!