- Humana (Columbus, OH)
- …to work independently under general instructions and with a team ** Preferred Qualifications** + Bachelor's degree + Previous experience in prior authorization, ... claims , and/or utilization management in healthcare, health insurance, evaluating...(collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and… more
- Medical Mutual of Ohio (OH)
- …enrollment, billing/refunds, broker portal troubleshooting, marketing materials, plan benefits, claims , etc. Coordinates with other internal business areas to ... Performs other duties as assigned. **Qualifications** **Education and Experience** + Associate 's degree in Marketing, Business Administration or related field. +… more
- Humana (Columbus, OH)
- …on beneficiary needs; assists with beneficiary related issues which may include claims inquiries, enrollment issues, travel attestations, access to care, wait lists, ... 8-hour shift Mon-Fri between the hours of 8 am to 7 pm EST. ** Preferred Qualifications** + Masters' degree in social work, psychology, or related health discipline… more
- Humana (Columbus, OH)
- …to an organization focused on growing and developing best practices ** Preferred Qualifications** + Knowledge of Medicaid regulations, programs, and state plan ... either the state agency or payer perspective + Detailed understanding of healthcare claims Travel: While this is a remote position, occasional travel to Humana's… more
- Deloitte (Dayton, OH)
- …by reviewing services, contracts, performance guarantees, and renewals. + Analyze claims utilization data and assess health plan performance against strategy. + ... industries/sectors you serve. + Limited immigration sponsorship may be available. Preferred Qualifications: + Master's degree in mathematics, statistics, or a… more
- Humana (Columbus, OH)
- …The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems of ... to an organization focused on continuously improving consumer experiences ** Preferred Qualifications** + Medical utilization management experience, + working with… more
- Humana (Columbus, OH)
- …cycle management (related to billing, coding, collections for Medicare and Medicaid claims ) + Experience with Auditing and monitoring of healthcare records + Must ... and regulations governed by the Department of Insurance and CMS ** Preferred Qualifications** + Compliance regulations knowledge and compliance auditing experience +… more
- Molina Healthcare (Cincinnati, OH)
- …advanced SQL queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. * Build and maintain efficient ... technical decisions. **JOB QUALIFICATIONS** **Required Education** * Bachelor's or Associate 's degree in Data Science, Computer Science, Analytics, Information… more
- Parker Hannifin Corporation (Cleveland, OH)
- …Apply Now > Save JobJob Saved SUMMARY: The Supply Chain Leadership Development Associate (SCM LDA) is a role that combines the development aspects of Parker's ... between suppliers and company personnel. + Negotiate and settle damage claims , rejections, losses, return of materials, over-shipments, cancellations and engineering… more
- CVS Health (Columbus, OH)
- …in a prepayment environment - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc. - Researches and prepares cases ... to travel and participate in legal proceedings, arbitrations, depositions, etc. ** Preferred Qualifications** 1-3 years experience working on health care fraud,… more