- Evolent (Columbus, OH)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and… more
- CVS Health (Columbus, OH)
- …people with military experience. As a Complaints Tracking Module (CTM) Senior Coordinator , you will be part of the Medicare Complaints Tracking Module (CTM) ... Team, responsible for researching and resolving Medicare complaints received via the Centers for Medicaid and Medicare Services (CMS). In this role, you will manage a queue of Medicare complaints. These complaints can include various issues ranging from claims… more
- CVS Health (Columbus, OH)
- …Appeal Coordinator ** coordinates reviews and evaluations for complaints and appeals received by the organization. This includes denied claims, coverage issues, ... and independently coaches others on matters regarding complaints and appeals . **In this role, you will:** + Handle quality...role, you will:** + Handle quality checks for the appeals team, in order to ensure overall accuracy. +… more
- ProMedica Health System (Toledo, OH)
- The Transition Coordinator is responsible for managing referrals and coordinating admissions for the transition of patients to and from the Flower Rehab Center. This ... and the community. This role actively collaborates with the FRC PPS Coordinator , Case Managers, Transition Care Managers, and Nursing and Therapy Leadership to… more
- Elevance Health (Dayton, OH)
- **LTSS Service Coordinator (Case Manager)** **Hiring statewide across Ohio** **Location** : This field-based role enables associates to primarily operate in the ... long term services and supports, and psychosocial needs. The **LTSS Service Coordinator ** is responsible for managing service coordination for a designated caseload… more
- CommonSpirit Health at Home (Loveland, OH)
- …mid-level role responsible for resolving insurance and self-pay accounts, including managing claim appeals . This role requires a high level of attention to detail to ... Proficiency in billing and collections processes, with a focus on insurance appeals and account resolution.. At CommonSpirit Health at Home, we are proud… more
- Cardinal Health (Columbus, OH)
- …industry including Commercial and Government plans, Prior Authorizations, and Appeals + Experience with Microsoft Office products including Word, PowerPoint, ... Teams, Outlook, and Excel + Excellent observation skills to easily identify trends and problems while providing solutions + Superior written & verbal communication skills + Required to effectively present information in a one-on-one and small group situations… more