- CVS Health (Columbus, OH)
- …plan - Efficiently use multiple systems and screens to obtain and record claim information - Review claims information to determine the nature of a member's ... it all with heart, each and every day. **Job Summary** Reviews and adjudicates claims in accordance with claim processing guidelines. Claim Benefit… more
- Molina Healthcare (Columbus, OH)
- …is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it ... applied to the appropriate modules within the core processing system (QNXT). * Conducts focal healthcare Medical claim...+ Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using… more
- Molina Healthcare (Columbus, OH)
- …and provides counsel to providers. Helps to mentor and coach Provider Claims Adjudicators. **Job Qualifications** **REQUIRED EDUCATION:** Associate 's Degree or ... , provider and investigation/research experience. Outcome focused and knowledge of multiple systems . 1+ years of claims research and/or issue resolution or… more
- Humana (Columbus, OH)
- …part of our caring community and help us put health first** The Bilingual Claims Research & Resolution Representative 2 manages claims operations that involve ... customer contact, investigation, and resolution of claims or claims -related financial issues. The position includes moderately complex call center,… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Claims Processing Representative 1 reviews and adjudicates complex or specialty claims , ... support/computational tasks. Typically works on routine and patterned assignments. The Claims Processing Representative 1 determines whether to return, deny, or pay… more
- Humana (Columbus, OH)
- …products, or other Medical management organizations, hospitals/ Integrated Delivery Systems , health insurance, other healthcare providers, clinical group practice ... (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
- Sedgwick (Cincinnati, OH)
- …+ Requests physician certification and/or extensions from medical offices and enters into claims system . + Documents telephone conversations pertinent to the ... Fortune Best Workplaces in Financial Services & Insurance Intake Associate **This position will be 12:00 PM - 8:00...or payment information to clients and claimants. + Enters claims data into claims management system… more
- Nestle (Solon, OH)
- …_This position is not eligible for Visa Sponsorship._ **Position Summary** The Account Associate is a key member of the Account Management team, providing support to ... account-focused support to assist in the achievement of annual sales. The Account Associate is responsible for alignment with the customer account team, managing the… more
- OhioHealth (Mansfield, OH)
- …and extent of any hospital exposure/liability; in collaboration with the Risk Manager, Systems Director, and/or the General Counsel, for claims within the ... **We are more than a health system . We are a belief system .**...Summary:** Given that the organization self-insures for professional liability claims , it is essential that the Sr Consultant Risk… more
- Otsuka America Pharmaceutical Inc. (Columbus, OH)
- **Job Summary** **Job Description** The Associate Director (AD), Federal Government Affairs, will assist in the development, communication, and deployment of ... Affairs and located in the Washington, DC area. The Associate Director will leverage Otsuka's resources including Otsuka US...impacting access to care within the health care delivery system , in accordance with Otsuka strategic objectives + Help… more