Top 676 Senior program specialist Jobs in Tennessee

Senior Claim Benefit Specialist - Remote
CVS Health —Tennessee
- $18.50 - $42.35 an hour
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- Mentoring
- Health insurance
- Dental insurance
13d
Assessment Specialist
Work from Home —Nashville, TN
- Full-time
- Mid-level
- Employee stock purchase plan
- Disability insurance
Quick Apply
Senior Informaticist
Centerwell —Tennessee
- $97,900 - $133,500 a year
- Full-time
- Remote
- Computer science
- Computer Science
- 3 years
- Paid parental leave
- Paid holidays
Senior Managed Care Specialist( Provider Enrollment )
St. Jude Children's Research Hospital —Memphis, TN
- $29.00 - $50.50 an hour
- Full-time
- Mid-level
- High school diploma or GED
- Epic
- Paid time off
Welding Engineer
Y12 —Oak Ridge, TN
- Bachelor of Science
- Engineering
- Pass drug screening
- Disability insurance
- Health insurance
4d
Senior Safety Specialist
McCormick Trucking —Murfreesboro, TN
- $65,000 - $80,000 a year
- Full-time
- Background check
- CPR Certification
- First Aid Certification
Quick Apply
4d
Structural Engineer
Y12 —Oak Ridge, TN
- Construction site
- Pass drug screening
- Mid-level
- Disability insurance
- Health insurance
Fire Protection System Engineer - UPF
Y12 —Oak Ridge, TN
- Bachelor of Science
- Engineering
- Pass drug screening
- Disability insurance
- Health insurance
Structural Engineer
Y12 —Oak Ridge, TN
- Construction site
- Pass drug screening
- Mid-level
- Disability insurance
- Health insurance
UPF Facility Safety Engineer
Y12 —Oak Ridge, TN
- Bachelor of Science
- Engineering
- Pass drug screening
- Disability insurance
- Health insurance
Piping Engineer
Y12 —Oak Ridge, TN
- Bachelor of Science
- Engineering
- Pass drug screening
- Disability insurance
- Health insurance
Radiology Specialist Tech
TriStar Skyline Medical Center —Nashville, TN
- Full-time
- Mid-level
- Radiology
- Cardiology
- Employee stock purchase plan
- Disability insurance
Quick Apply
10d
Project Controls Specialist
KeyLogic Systems —Oak Ridge, TN
- Background check
- 5 years
- Bachelor of Science
Quick Apply
4d
Engineering Support Specialist
Y12 —Oak Ridge, TN
- Pass drug screening
- Mid-level
- Master's degree
- Disability insurance
- Health insurance
Cardiovascular Technologist
TriStar Hendersonville Medical Center —Hendersonville, TN
- Full-time
- 8 years
- Senior level
- Radiology
- Employee stock purchase plan
- Disability insurance
Quick Apply
Marketing & Communications Manager
Empower Ministry by the Isaacson Foundation —Gallatin, TN
- $80,000 - $130,000 a year
- Full-time
- Background check
- Marketing
- English
- Health insurance
- Paid time off
Quick Apply
8d
Radiologic Technologist OR Specialist
Parkridge Medical Center —Chattanooga, TN
- Full-time
- Surgery
- Mid-level
- Children
- Employee stock purchase plan
- Disability insurance
Quick Apply
Senior Maintenance Specialist (Day-Shift)
University of Tennessee Medical Center —Knoxville, TN
- $25 - $28 an hour
- Full-time
- Hospital
- 5 years
- High school diploma or GED
- Health savings account
- Health insurance
Quick Apply
Chemical Process Design Engineer
Y12 —Oak Ridge, TN
- Bachelor of Science
- Engineering
- Pass drug screening
- Disability insurance
- Health insurance
INF Work Control Supervisor
Y12 —Oak Ridge, TN
- Pass drug screening
- 3 years
- High school diploma or GED
- Disability insurance
- Health insurance
3d

I want to receive the latest job alert for senior program specialist in tennessee

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

senior program specialist jobs near tennessee

Senior Claim Benefit Specialist - Remote

CVS Health -
Tennessee

Apply Now

Job Details

Full-time
$18.50 - $42.35 an hour
13 days ago

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

High school diploma or GED
Health insurance knowledge

Full Job Description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary
Reviews and adjudicates complex, sensitive, and specialized medical claims in accordance with established plan processing guidelines. Functions as a subject matter expert by providing coaching, and offering guidance on escalated or technically challenging issues. Supports customer service operations by addressing inquiries and resolving issues to ensure a positive member experience.

Additional Responsibilities

Reviews pre‑specified claims and those that exceed specialist adjudication authority or processing expertise.
Applies medical necessity guidelines, determines coverage, verifies eligibility, identifies discrepancies, and implements cost‑containment measures to support accurate claim adjudication.
Ensures compliance with all regulatory requirements and confirms that payments align with company policies and procedures.
Identifies and reports potential overpayments, underpayments, and other claim irregularities.
Performs claim rework calculations as needed.
Trains and mentors as needed to enhance team performance and technical proficiency.
Conducts outbound calls to obtain required information for claims or reconsideration requests.

Required Qualifications

Minimum of 18 months of medical claim processing experience with a health insurance payor or third‑party administrator.
Proven success working in a high‑volume, production‑driven environment.
Demonstrated ability to manage multiple assignments with accuracy, efficiency, and attention to detail.

Preferred Qualifications

Self-Funding experience
DG system knowledge

Education

High School Diploma required
Preferred Associates degree or equivalent work experience.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $42.35

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Apply Now

Refine Your Search

senior program specialist jobs in tennessee

Senior Claim Benefit Specialist - Remote

Assessment Specialist

Senior Informaticist

Senior Managed Care Specialist( Provider Enrollment )

Welding Engineer

Senior Safety Specialist

Structural Engineer

Fire Protection System Engineer - UPF

Structural Engineer

UPF Facility Safety Engineer

Piping Engineer

Radiology Specialist Tech

Project Controls Specialist

Engineering Support Specialist

Cardiovascular Technologist

Marketing & Communications Manager

Radiologic Technologist OR Specialist

Senior Maintenance Specialist (Day-Shift)

Chemical Process Design Engineer

INF Work Control Supervisor

I want to receive the latest job alert for senior program specialist in tennessee

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected