- Intermountain Health (Columbus, OH)
- …**Essential Functions** + Oversees the day-to-day revenue cycle functions including claims processing, denials, payments, customer service, and follow up on ... contractual arrangements affecting payments, to research incomplete, incorrect or outstanding claims and/or patient issues. Investigates and resolves claims … more
- Otsuka America Pharmaceutical Inc. (Columbus, OH)
- …and external regulations. This position reports directly to the Associate Director, CNS Scientific Communications. **Job Description** **Key Responsibilities ... **Core Content Development** + Under the guidance of the Associate Director, Medical Communications, draft and maintain high-priority, foundational scientific… more
- Humana (Columbus, OH)
- …and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to ... data mining, detects anomalies in data to identify and collect overpayment of claims . Contributes to the investigations of fraud waste and our financial recovery.… more
- Humana (Columbus, OH)
- …and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to ... put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct...Associates will work on EST, regardless of where the associate resides. Work hours can vary slightly, but all… more
- Humana (Columbus, OH)
- …and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to ... encompasses critical functions including care coordination, quality measurement, billing, claims processing, and customer service, each essential to delivering a… more
- Otsuka America Pharmaceutical Inc. (Columbus, OH)
- …seek to shape and implement best practices, ensure efficient processes, and support the delivery of high-quality medical plans. This role ensures alignment between ... planning teams to enhance collaboration across Otsuka + Consider technology and AI to support workflow improvement + Serve as a key point of contact for senior… more
- Zurich NA (Columbus, OH)
- …and systems integration You will lead cross-functional transformation initiatives, support operational planning and performance reviews, and help build the ... satisfaction. + Seamless integration of systems and tools that support scalable growth. + Strong cross-functional alignment and a...and 7 or more years of experience in the Claims , Consulting, Risk Engineering or Underwriting area OR *… more
- Humana (Columbus, OH)
- …and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to ... the AAPC and/or AHIMA) + Extensive knowledge of medical claims processing and familiarity with reimbursement methodologies, ICD, CPT,...field + Knowledge of internal Medical Coverage Policies and Claims Payment Policies + CAS claims processing… more
- Humana (Columbus, OH)
- …and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to ... 2 ensures contract compliance and performs analysis regarding pharmacy claims . Understands department, segment, and organizational strategy and operating objectives,… more
- Fifth Third Bank, NA (Cincinnati, OH)
- …previously filed dispute. This may include specialized disputes, including denied claims , reassertions, repeat offenders, and Private Bank client customers. The ... Commercial Code (UCC) and Regulation E and Regulation Z claims . The Analyst uses various bank and vendor systems...Disputes, Fraud, Banking, or a related field preferred. + Associate 's degree or equivalent work experience. + Strong analytical,… more