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Remote Eap Manager Jobs in Tennessee (NOW HIRING)

QualDerm Partners

Physician Liaison - TN

Nashville, TN · On-site +1

**Hybrid Role - Visiting Clinics and Remote** Company Overview: QualDerm Partners manages leading ... Employee Assistance Program (EAP) - Access confidential support for personal or work-related ...

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Remote Eap Manager information

What is the difference between Remote Eap Manager vs Remote Employee Assistance Program Coordinator?

AspectRemote Eap ManagerRemote Employee Assistance Program Coordinator
CredentialsTypically requires a master's degree in psychology, counseling, or social work; certifications like CEAP are commonOften requires a bachelor's or master's in related fields; certifications like CEAP are advantageous
Work EnvironmentManages EAP services, supervises staff, develops programs, often in corporate or healthcare settingsCoordinates EAP services, provides counseling, and supports employees directly or indirectly
Employer & Industry UsageUsed by large corporations, healthcare providers, and HR departmentsUtilized by HR teams, wellness programs, and employee support services

The main difference is that the Remote Eap Manager oversees the entire EAP program and manages staff, while the Remote Employee Assistance Program Coordinator focuses on providing direct support and coordinating services. Both roles require relevant certifications and are integral to employee well-being in corporate settings.

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What job categories do people searching Remote Eap Manager jobs in Tennessee look for? The top searched job categories for Remote Eap Manager jobs in Tennessee are:
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Remote Eap Manager jobs near you

Claims Auditor- Remote

American Health Partners

Franklin, TN • On-site, Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 3 days ago

Job description

American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reside in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by improving patient care to reduce emergency room visits and avoidable hospitalizations. This division currently operates in Tennessee, Georgia, Missouri, Kansas, Oklahoma, Utah, Texas, Mississippi, Louisiana, Iowa, and Idaho with planned expansion into other states in 2024. For more information, visit AmHealthPlans.com.
If you would like to be part of a collaborative, supportive and caring team, we look forward to receiving your application!
Benefits and Perks include:
  • Affordable Medical/Dental/Vision insurance options
  • Generous paid time-off program and paid holidays for full time staff
  • TeleMedicine 24/7/365 access to doctors
  • Optional short- and long-term disability plans
  • Employee Assistance Plan (EAP)
  • 401K retirement accounts
  • Employee Referral Bonus Program

ESSENTIAL JOB DUTIES:
To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation.
  • Conduct pre-pay and post-pay audits to ensure accurate claims payments and denials
  • Ensure regulatory compliance and overall quality and efficiency by utilizing strong working knowledge of claims processing standards
  • Work closely with delegated claim processor to ensure errors are reviewed and corrected prior to final payment
  • Work assigned claim projects to completion
  • Provide a high level of customer service to internal and external customers; achieve quality and productivity goals
  • Escalate appropriate claims/audit issues to management as required; follow departmental/organizational policies and procedures
  • Maintain production and quality standards as established by management
  • Participate in and support ad-hoc audits as needed
  • Other duties as assigned

JOB REQUIREMENTS:
  • Proficient in processing/auditing claims for Medicare and Medicaid plans
  • Strong knowledge of CMS requirements regarding claims processing, especially regarding skilled nursing facilities and other complex claim processing rules and regulations
  • Current experience with both Institutional and Professional claim payments
  • Knowledge of automated claims processing systems
  • Hybrid role that may require 2-3 days per week onsite at the Franklin, TN office.

REQUIRED QUALIFICATIONS:
  • Experience:
    • Two (2) years' experience with complex claims processing and/or auditing experience in the health insurance industry or medical health care delivery system
    • Two (2) years' experience in managed healthcare environment related to claims processing/audit
    • Two (2) years' experience with standard coding and reference materials used in a claim setting, such as CPT4, ICD10 and HCPCS
    • Two (2) years' experience with CMS requirements regarding claims processing; especially Skilled Nursing Facility and other complex claim processing rules and regulations
    • Two (2) years' experience processing/auditing claims for Medicare and Medicaid plans
  • License/Certification(s):
    • Coding certification preferred

EQUAL OPPORTUNITY EMPLOYER
Our Organization does not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. The Organization will also make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made.
This employer participates in E-Verify.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.
American Health Partners logo

About American Health Partners

Sourced by ZipRecruiter

American Health Partners is a family of six divisions staffed by outstanding employees who care deeply about others. Since our inception more than 45 years ago, we have been committed to bringing the highest quality healthcare available to our communities. That commitment continues to serve us, our patients, our customers and our partners well. Today, our diverse healthcare offerings serve nearly 12,000 individuals annually across multiple states. We operate in both urban and rural communities where people need healthcare close to home. By working closely with hospitals and other providers, we offer cost-effective options that give individuals greater control over their healthcare.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

Franklin, TN, US

Year founded

1976

Social media

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