- Sedgwick (Columbus, OH)
- …and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on ... projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles...claim status; and provides written resumes of specific claims as requested by client. + Assures that direct… more
- Sedgwick (Columbus, OH)
- …or university preferred . **Experience** 2-3 years experience processing work comp claims as an examiner . Familiar with CPT, DRG and resources established ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Work Comp Claims Negotiator **PRIMARY PURPOSE** **:** To negotiate Out of Network bills that do… more
- Molina Healthcare (OH)
- …Experience** + 2+ years of experience working in the group health business preferred , particularly within claims processing or operations. + A demonstrated ... Association** + AAPC Certified Medical CPC, CPMA, CPCO or similar specialist preferred + Certified Fraud Examiner and/or AHFI professional designations … more
- Sedgwick (Dublin, OH)
- …and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on ... projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles,...claim status; and provides written resumes of specific claims as requested by client. + Assures that direct… more
- Prime Therapeutics (Columbus, OH)
- …and understanding of pharmacy and medical claims processing environment ** Preferred Qualifications** + Certified Fraud Examiner (CFE) or Accredited Health ... and/or prescriber fraud, waste and abuse (FWA). This position conducts claims data mining, fraud analysis and auditing/monitoring activities and proactively… more
- Sedgwick (Columbus, OH)
- …policies within assigned group. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Completes examiner update reports, claim adjustments, provider requests and ... Licensing** High School diploma or GED required. Associate degree preferred . **Experience** Two (2) years of claims ...degree preferred . **Experience** Two (2) years of claims management or insurance experience or equivalent combination of… more