Top 52 Claims lead Jobs in Tennessee

Home Health & Hospice Billing Lead (Hybrid)
Pennant Services —Nashville, TN
- Full-time
- Hybrid work
- Finance
- Analysis skills
- Continuous improvement
- Health insurance
- Dental insurance
Quick Apply
Transportation Liability Claims Leader
Averitt —Cookeville, TN
- Full-time
- 18 years or older
- 5 years
- High school diploma or GED
- Profit sharing
- Paid holidays
13d
Lead Director, Healthcare Medicaid Risk Adjustment Analytics
CVS Health —Tennessee
- $100,000 - $231,540 a year
- Full-time
- Remote
- 3 years
- SQL
- Bachelor's degree
- Health insurance
- Dental insurance
Lead Director, Risk Adjustment Performance Reporting and Insights
CVS Health —Tennessee
- $100,000 - $231,540 a year
- Full-time
- Remote
- Computer Science
- Bachelor's degree
- Mentoring
- Health insurance
- Dental insurance
10d
Lead Director, Stop Loss Relationship Management
CVS Health —Nashville, TN
- $100,000 - $231,540 a year
- Full-time
- Bachelor's degree
- Fair chance
- Experience equivalent to degree accepted
- Health insurance
- Dental insurance
Lead, Supply Chain & Logistics Operations
Bridgestone Americas —Nashville, TN
- Full-time
- Customer service
- Mid-level
- 3 years
- Flexible spending account
12d
Lead Director, Medicare Advantage and Group ACA Risk Adjustment Informatics
CVS Health —Tennessee
- $100,000 - $231,540 a year
- Full-time
- Remote
- Computer Science
- SQL
- Bachelor's degree
- Health insurance
- Dental insurance
10d
Healthcare Market Finance Lead
Humana —Tennessee
- $104,000 - $143,000 a year
- Full-time
- CPA
- Office
- Master's degree
- Paid parental leave
- Paid holidays
Sr. Manager, AI Lead - Semantic Layer - Remote
CSAA Insurance Services, Inc. —Tennessee
- $168,300 - $224,300 a year
- Full-time
- Computer science
- Product management
- US work authorization
- 401(k) matching
6d
Rural Health Transformation Program Lead
Delta Dental of Michigan —Nashville, TN
- Full-time
- Hybrid work
- Marketing
- 5 years
- Bachelor's degree
- Dental insurance
- Opportunities for advancement
Workforce Absence Team Lead
Sedgwick —Memphis, TN
- Hybrid work
- 6 years
- Computer literacy
- Writing skills
- Health savings account
- Disability insurance
6d
Lead Account Reimbursement Specialist (Self-pay Follow Up / Quality Assurance)
Vanderbilt Health —Nashville, TN
- Full-time
- Mid-level
- High school diploma or GED
- Continuous improvement
- Health insurance
6d
Revenue Lead, ROPS
DAVITA —Brentwood, TN
- $22.50 - $31.00 an hour
- Overtime
- Computer literacy
- Mid-level
- High school diploma or GED
- Health insurance
- Dental insurance
12d
Epic Payer Platform Lead
Accenture —Nashville, TN
- $87,400 - $266,300 a year
- Full-time
- Hybrid work
- 6 years
- Office
- US work authorization
- Paid holidays
- Disability insurance
Lead Wheelchair
Menzies Aviation —Memphis, TN
- Overtime
- Background check
- 18 years or older
- Ability to walk for extended periods
Collections Escalation Lead Analyst
Deloitte —Hermitage, TN
- Full-time
- Office
- Bachelor's degree
- Continuous improvement
Systems Administrator Lead- Cameras/ VMS
City of Chattanooga, TN —Chattanooga, TN
- $64,024 - $77,348 a year
- Full-time
- Background check
- Computer Science
- Office
- Health insurance
- Paid time off
Lead Charge Master, Revenue Integrity Analyst (Pharmacy)
Regional One Health —Memphis, TN
- Full-time
- Research
- Bachelor's degree
- Mentoring
Lead Pharmacist, Pharmacy Supply Chain
Regional One Health —Memphis, TN
- Full-time
- Hospital
- Customer service
- Data analysis skills
- Employee discount
Inventory Leader
Moca Logistics & Industrial Solutions —Chattanooga, TN
- From $47,480 a year
- Spanish
- CPR Certification
- English
Quick Apply

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Home Health & Hospice Billing Lead (Hybrid)

Pennant Services -
Nashville, TN

Quick Apply

Job Details

Full-time

Benefits

Health insurance
Dental insurance
401(k)
Vision insurance

Qualifications

Staff supervision
Healthcare staff management
Medicare
Accounts receivable management
Medicare coding guidelines
Team leadership
Medical coding
CMS
Regulatory compliance in claims processing
Medical billing compliance checks
Certified Professional Coder
ICD-10
CMS regulatory compliance
Health insurance knowledge
Medicare regulations
Centers for Medicare & Medicaid Services (CMS) billing regulations
Medicaid regulations
Medical claims submission
Medicaid
Home healthcare regulations
Medical Billing Certification
Clinical documentation standards
Associate's degree
Managing medical billing & coding team teams
Medical billing insurance follow-up

Full Job Description

POSITION SUMMARY: The Billing Lead is responsible for the daily leadership of the team that handles all billing functions for our home health and hospice services. This is a hands-on leadership role that requires expert knowledge of Medicare, Medicaid, and commercial billing regulations, a commitment to low denial rates, and efficient accounts receivable management.

ESSENTIAL RESPONSIBILITIES AND DUTIES INCLUDE BUT ARE NOT LIMITED TO THE FOLLOWING:

Prepares, reviews, and accurately submits institutional claims (e.g., UB-04s/CMS-1450s) to Medicare, Medicaid, and all commercial insurance carriers via electronic submission.
Leads, trains, and mentors the billing team, setting performance goals, distributing workload, and providing mentorship to optimize accuracy and productivity.
Oversees the preparation, review, and compliant electronic submission of all claims (e.g., final claims, RAPs/NOEs, adjustments) to Medicare, Medicaid, and commercial payers.
Directs the team’s efforts in daily payment posting, reconciliation, and managing the accounts receivable aging to ensure low DSO (Days Sales Outstanding).
Implements and monitors processes for the prompt research, correction, and resubmission of denied and rejected claims, identifying and addressing root causes to improve first-pass acceptance rates.
Ensures all billing practices adhere strictly to CMS (Medicare), state Medicaid, and commercial payer guidelines, maintaining readiness for all internal and external audits.
Maintains expert-level knowledge of current billing rules, including the home health Patient-Driven Groupings Model (PDGM) and hospice payment system, ensuring correct revenue codes and payment calculations are used.
Works closely with the Intake and Authorization teams to resolve eligibility or authorization-related billing hurdles, and with Clinical Documentation to ensure charts support the services billed.
Other appropriate services and special projects as assigned.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

QUALIFICATIONS & REQUIREMENTS FOR THE POSITION:

Minimum of four (4) years of experience in healthcare medical billing, with at least two (2) years specifically in home health or hospice billing.
Minimum of one (1) year of leadership or supervisory experience managing a billing or accounts receivable team.
Expert proficiency with a major home health or hospice EMR and Billing system (e.g., HCHB, Kinnser/WellSky, MatrixCare).
Comprehensive knowledge of ICD-10 coding, CPT codes, and all institutional claim forms (UB-04/CMS-1450).
Deep understanding of Medicare and Medicaid billing regulations for home health and hospice services.

PREFERRED KNOWLEDGE AND SKILLS:

Associate's or Bachelor's degree in Business, Accounting, Finance, or a related field.
Certification in Medical Billing and Coding (e.g., CPC, COC).
Exceptional analytical skills with a strong aptitude for numbers and detailed data analysis.
Proven ability to troubleshoot complex billing issues and manage high-volume transactional workloads.
Excellent written and verbal communication skills for effective communication with payers, staff, and management.
High level of professionalism and integrity with a focus on regulatory compliance.
Proactive problem-solver with a focus on continuous process improvement.

SUPERVISORY RESPONSIBILITIES:

May supervise the team that handles all billing functions for home health and hospice services.

About Us

Synergy Shared Services is a newly formed company in the Pennant family. The hub is in Nashville, TN. Synergy’s focus is to build strong relationships with operations by being a trusted partner in delivering high-performance results across a range of essential office workflow functions.

Our goals include each home health and hospice operation feeling like the people that work at the Synergy hub are their people – that they are a teammate who is passionate about the results of the operations they are partnered with.

Job Type: Full-time

Benefits:

401(k)
Dental insurance
Health insurance
Vision insurance

Experience:

healthcare medical billing: 4 years (Required)
home health or hospice billing: 2 years (Required)
ICD-10 coding, CPT codes: 1 year (Required)

License/Certification:

Certification in Medical Billing and Coding (Preferred)

Work Location: Hybrid remote in Nashville, TN

Quick Apply

Refine Your Search

claims lead jobs in tennessee

Home Health & Hospice Billing Lead (Hybrid)

Transportation Liability Claims Leader

Lead Director, Healthcare Medicaid Risk Adjustment Analytics

Lead Director, Risk Adjustment Performance Reporting and Insights

Lead Director, Stop Loss Relationship Management

Lead, Supply Chain & Logistics Operations

Lead Director, Medicare Advantage and Group ACA Risk Adjustment Informatics

Healthcare Market Finance Lead

Sr. Manager, AI Lead - Semantic Layer - Remote

Rural Health Transformation Program Lead

Workforce Absence Team Lead

Lead Account Reimbursement Specialist (Self-pay Follow Up / Quality Assurance)

Revenue Lead, ROPS

Epic Payer Platform Lead

Lead Wheelchair

Collections Escalation Lead Analyst

Systems Administrator Lead- Cameras/ VMS

Lead Charge Master, Revenue Integrity Analyst (Pharmacy)

Lead Pharmacist, Pharmacy Supply Chain

Inventory Leader

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