• Service Center Representative- Blue Ash|…

    Sedgwick (Cincinnati, OH)
    …to callers regarding claims for multiple lines of business; to expedite the claims application process and provide detailed claim notes on all calls; to ... advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall.… more
    Sedgwick (06/03/25)
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  • DRG Coding Auditor

    Elevance Health (Mason, OH)
    …AUDITOR** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of ... and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside...Health Information Technician and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder. +… more
    Elevance Health (08/13/25)
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  • Health Plan Operations, Payment Integrity Program…

    Molina Healthcare (Akron, OH)
    …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... for all PI solutions. + Lead efforts to improve claim payment accuracy, claim referrals, adjustment analysis...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… more
    Molina Healthcare (08/14/25)
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  • Team Lead Billing and Follow-Up - CBO Revenue…

    ProMedica Health System (Toledo, OH)
    …of facility claims to the third-party payors. In addition to claim submission, responsibilities include timely corrections of all assigned claim rejection ... party payers appropriately if there is no response after claim submission. The HB Billing and Follow-Up - Team...direct elbow support to the HB Billing and Follow-Up Specialist I's & II in resolving complex barriers. Keep… more
    ProMedica Health System (08/09/25)
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  • Payment Integrity Program Manager - Health Plan

    Molina Healthcare (Akron, OH)
    …and financial outcomes for all PI solutions. + Leads efforts to improve claim payment accuracy, claim referrals, adjustment analysis and financial performance ... Analysis** + Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. + Applies understanding of… more
    Molina Healthcare (08/14/25)
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  • Lead Analyst, Payment Integrity

    Molina Healthcare (OH)
    …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... SAI targets are met. + Leads efforts to improve claim payment accuracy and financial performance without needing extensive...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… more
    Molina Healthcare (08/14/25)
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  • Field Reimbursement Manager

    Adecco US, Inc. (Cincinnati, OH)
    …assigned providers and healthcare offices, supporting patient access + Conduct benefit investigations, prior authorizations, appeals, and claim denials follow-up ... Specialty Pharmacy, Medicare, and Commercial payer structures + Experience with benefit verifications, prior authorizations, claims appeals, and HUB services… more
    Adecco US, Inc. (07/29/25)
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  • Patient Registration

    Robert Half Office Team (Cincinnati, OH)
    …join our client's team in Cincinnati, Ohio, as a Patient Registration Specialist . This Contract-to-Permanent position offers the opportunity to contribute to a ... with accuracy and confidentiality. * Process payments and assist with insurance claim submissions. * Monitor and order office supplies to ensure the department… more
    Robert Half Office Team (07/22/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Mason, OH)
    …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
    Elevance Health (08/13/25)
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  • Human Resources Generalist

    Aeroseal (Miamisburg, OH)
    …department. This role focuses on leave administration, workers' compensation, unemployment claims , compliance, employee relations, and general HR support across the ... and HR best practices. + Experience handling workers' compensation and unemployment claims . + Strong organizational skills with attention to detail. + Ability to… more
    Aeroseal (08/16/25)
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